For a new patient first visit, please download, print and complete this form:
Outpatient Information/Consent to Treat - Adult
Download, print and complete this form to authorize release of protected health information:
Authorization to Disclose Protected Health or Billing Information
Download, print and complete to acknowledge receipt of joint notice of privacy practices:
HIPAA-Acknowledgement of Receipt of Joint Notice of Privacy Practices
Download, print and complete current medication list to bring for appointments:
Monday to Wednesday
8 a.m. to 7 p.m.
Thursday & Friday
8 a.m. to 5 p.m.
Our office is conveniently located off of Matthews Township Parkway and Sam Newell Road.
View map & contact information.