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Patient Forms

We are happy to provide you with HIPAA-secure forms that you can fill out right on your computer. No printing or handwriting necessary! Simply find the form you need below, click on it and the form will open in a new window. Fill it out right on your computer and hit the “submit” button at the bottom of the form. We will receive your form through our HIPAA-secure email and have it ready to go before you arrive for your appointment. It's that easy!

Children's Head Injury History Form

Please print this form, fill it out and bring it to your next appointment if your child has had a head injury.

Children's Vision and Learning Questionnaire

Please fill out the extended form if your child has trouble with reading, homework or struggles in school.

Adult Head Injury or Stroke History

Please print this form, fill it out and bring it to your next appointment.

Adult History Form

Please print this form, fill it out and bring it to your next appointment.

Privacy and Financial Policies

Please print this form, fill it out and bring it to your next appointment.

Release of Information Form

Please print this form, fill it out and bring it to your next appointment.

Covid Patient Waiver Form

Please print this form, fill it out and bring it to your next appointment.