Health History Forms

Please complete the Patient Health History form for your first visit. This document is necessary for your complimentary examination. We’ve provided three options for completing the Health History Form. Select one of the following:

Option 1

Fill out our secure online Patient Health History form.

The information will be submitted to our office upon completion.

Online Patient Health History Form

Option 2

Download and print a PDF version of the Patient Health History form.

Fill it out and bring it with you to your first appointment.

Patient Health History Form – PDF

Option 3

Download and print a Microsoft Word version of the Patient Health History form.

Please note: This will download a file to your computer. Fill it out and bring it with you to your first appointment.

Patient Health History Form – MS Word format

If you need assistance or have any questions, please feel free to give us a call. We’ll be happy to assist you with this first step.