WE DO NOT ACCEPT INSURANCE
Prior to your first appointment, please download the following forms. We have given you several options which make it easier for you to access and provide this information quickly to us.
- Check List of Current Symptoms
- Patient Medical History and Symptom Information
- Medical Disclosure
- Mandatory Office Policy
- Informed Consent for Treatment of Persistent Lyme Disease
- Consent for Release Information
- Sample HIPAA Release Form
- PCP Information
Bring the completed Patient History & Symptom Information form with you to your first appointment:
- Print the forms.
- And then, fill out by hand.