Click below to download PDF versions of our patient forms. Please print, fill out and bring in to your appointment.
New Patient Checklist
- Arrive 20 minutes prior to your appointment to allow time to complete your chart
- Bring a Photo ID that includes your name & picture.
- Bring a utility bill if your address is different than what appears on your driver's license. Refer to the above Red Flag Rule.
- Bring your current insurance card(s)*.
- Bring a current medication list.
- Bring Power of Attorney Forms if needed.
- Be Prepared to pay any co-pays if applicable.
* If your insurance requires a referral, it is your responsibility to have that in place.
** If you are unable to keep your appointment, please call the office at (330) 899-9160 to cancel or reschedule at least 24 hours in advance.
Please note, there will be a charge for any missed appointments.