New Patient Forms New Patient Forms Please complete and submit the forms before you come to one of our offices, or print the forms and bring them with you to your appointment. Patient's Name First Name Middle Name Last Name Birth Date - Month - Day Year Today's Date - Month - Day Year Primary Care Provider Referred By Reason for Visit Pharmacy & Location Medical History Has the patient been diagnosed with any of the following? (Include date of diagnosis) Complete More Information Below Arthritis ADD/ADHD New Patient Information Your First Appointment Complete and submit the New Patient Forms online or print, complete and bring them with you to the appointment. Bring a photo ID and your current insurance card. If your insurance requires a referral, please obtain one. Bring all of your medications (over the counter or prescription) to the appointment. For your convenience, we accept cash, checks, VISA, Master Card, American Express and Discover. Payment is expected at the time of service, unless other arrangements are made in advance. If you are unable to keep the appointment we request a 48 hour cancellation notice so that we may offer this time to another patient. Information for Allergy Skin Test Appointments Please be on time. Late arrival may result in your appointment being rescheduled. Allow approximately 2 hours for the appointment. Discontinue any medications that contain antihistamines for 3 - 7 days (depending on the medication) prior to the appointment. Click here for a detailed list. Perfumes and Colognes As a courtesy to our other patients who are sensitive to odors, please do not wear perfumes, colognes or scented lotions while in our office.