New Patients, please complete these forms and either email them to us prior to your appointment or print them out and bring the completed forms with you to your first appointment. 

If you decline to fill out these forms before your appointment, then please arrive 25 minutes prior to your appointment time. 

Financial Responsibilities Form

Patient History Form

(Please fill out completely) 

HIPPA Acknowledgement Receipt

Medical Records Release

(complete this ONLY if you need to request medical records for an upcoming appointment) 

(805) 527-8055

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