As part of our initial appointment we like to review your medical history to ensure you are an appropriate candidate for the care we provide. Please fill out the following form and submit it electronically. If there is any question you do not understand or do not wish to answer, leave it blank. We know the form is long, and we thank your for your effort in filling it out. We promise it will save you a lot of form-filling time at your appointment. We look forward to meeting with you soon!
BE CAREFUL not to press the Enter key as it may cause the form to submit prematurely. Also, it is more reliable to submit via computer than phone.