Patient Information

Consultation

On your first visit to our office, you will be asked to complete a questionaire which will become part of your established medical record. In addition to basic registration, this questionaire will request the following information:

Medical History including: medical problems and associated medical conditions, allergies and medications
Referring Physician
Emergency Contact Information
Type of Medical Insurance
Insurance Card (will need the name and mailing address of the company, your group number and policy number)


		Consultation On your first visit to our office, you will be asked to complete a questionaire which will become part of your established medical record. In addition to basic registration, this questionaire will request the following information: Medical History including: medical problems and associated medical conditions, allergies and medications Referring Physician Emergency Contact Information Type of Medical Insurance Insurance Card (will need the name and mailing address of the company, your group number and policy number)