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For your convenience, print and fill out before the first visit.
Acknowledgment of review of the notice of privacy practices. Please print and sign.
Please read and bring a signed copy.
To give us permission to treat your minor child without your presence, please complete and bring it to their next appointment.
Please review our Medical Records Release Form.
Appointment Cancellation, Reschedule, Missed Appointment, Product Return & Refund Policy.