Forms

Thank you for taking a few minutes to fill out the forms for your appointment. Completing the forms helps make your visit more efficient. Also, if you have an issue that may be more appropriate for another setting, we can let you know beforehand, and it may save you some time and money.

New patients

Complete the "New patient form" at the link below and then look under Issues and complete the form(s) for the issue(s) you want to be seen for. For example, if you want to be seen for weight loss, complete the "Weight loss" form. If you don't find a form that fits your issue, complete the "Other issue form."

• New patient form

Established patients

Please look under Issues below and complete the form(s) for the issue(s) you want to be seen for. If your medical or personal information has changed since the last time we saw you, please complete the appropriate form below.

• Medical information change
• Personal information change

Issue forms

• Weight loss / Overweight
• Other issue (form not found)
• Alcohol use disorder
• Allergies, seasonal
• Anxiety
• Asthma
• Back pain
• Birth control
• Cough
• Crohn's disease
• Depression
• Diabetes, Type 1
• Diabetes, Type 2
• Eczema / Atopic dermatitis
• Erectile dysfunction (ED)
• Eye redness / discharge
• Fever blisters / Cold sores
• Gout
• Herpes, genital
• High cholesterol
• Menopause / Hormone replacement therapy
• Hypertension (high blood pressure)
• Hypothyroidism / Low thyroid
• Insomnia
• Migraine headache
• Neck pain
• Opioid use disorder
• Weight loss / Overweight
• Poison ivy / Contact dermatitis
• Psoriasis
• Psoriatic arthritis
• Rash
• STD screening / infection (female)
• STD screening / infection (male)
• Urinary tract infection / UTI (female)