New Patients

Please print the appropriate New Patient Form — both front and back sides — and bring it with you on your first visit to our office.

New Patient Form
Adult - Front Side


New Child Patient Form
Child Under 16 - Front Side
New Patient Form
Adult - Back Side


New Child Patient Form
Child Under 16 - Back Side




Payment Options to Meet Your Needs
Insurance plans welcome
All major credit cards accepted
Personal checks accepted
Citi Health Card Finance
Care Credit

We are pleased to offer Citi Health Card financing. Choose from no interest and budget payment plans with low monthly payments. This card is accepted everywhere MasterCard is accepted. You can also use this account for other healthcare needs such as prescriptions and medical equipment.

Call for further details
(405) 840-4544