Our Patient History Form is now Electronic!

History Form

We are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant. This information is electronically transmitted into your chart, so no paper is used since we are paperless everywhere in our office (except the bathroom!)

**This form is currently not Mac/Safari or Google Chrome compatible. If you do not have access to a PC with Internet Explorer, Firefox or if you have any trouble filling out the forms on your computer, you are welcome to fill them out in our office or print them out and bring them with you to your appointment.