For your convenience, several of our forms are available online. Covid-19 Practice & Appointment UpdatesPAGE 3: COVID-19 Screening FormREAD before your visit. Updated 10/30/2021. Child/Teen RegistrationLess than 18 years of age.Online form for NEW patients. Established patients- submit only IF directed by our office. Adult Registration18+ years of ageOnline form for NEW patients. Established patients- submit only IF directed by our office. Patient Wellness Screening & Consent Visitor Wellness Screening & Consent Credit Card AuthorizationPlease print and complete if you wish to enroll in the automatic monthly credit card payment service. Stop Credit Card PaymentsOnline form to discontinue recurring credit card payments. Insurance IntakeOnline form to provide your insurance details. Notice Of Privacy PracticesExplanatory information: For your reference.