Patient Forms

Please download and print the patient forms below before your first visit. This will allow you to walk right in and be ready for your appointment!

New Patient Information Forms

Financial Contract Form

Social Security Number Request Form

Privacy Information Forms

Contact Us

Send Us an Email

Our Location

Find us on the map

Hours of Operation

Find Out When We Are Open

Monday:

8:00 am-5:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

8:00 am-5:00 pm

Thursday:

8:00 am-5:00 pm

Friday:

9:00 am-3:00 pm

Saturday:

Closed

Sunday:

Closed

(function(global) { //utiility functions /////// if (!Array.prototype.indexOf) { Array.prototype.indexOf = function(obj, start) { var i, j; i = start || 0; j = this.length; while (i < j) { if (this[i] === obj) { return i; } i++; } return -1; }; } //////// var parseQueryString = function(url) { var a = document.createElement('a'); a.href = url; str = a.search.replace(/\?/, ''); return deparam(str, true /* coerce values, eg. 'false' into false */); }; var each = function (arr, fnc) { var data = []; for (i = 0; i < arr.length; i++) data.push(fnc(arr[i])); return data; }; // deparam // // Inverse of $.param() // // Taken from jquery-bbq by Ben Alman // https://github.com/cowboy/jquery-bbq/blob/master/jquery.ba-bbq.js var isArray = Array.isArray || function(obj) { return Object.prototype.toString.call(obj) == '[object Array]'; }; var deparam = function( params, coerce ) { var obj = {}, coerce_types = { 'true': !0, 'false': !1, 'null': null }; // Iterate over all name=value pairs. each( params.replace( /\+/g, ' ' ).split( '&' ), function(v, j){ var param = v.split( '=' ), key = decodeURIComponent( param[0] ), val, cur = obj, i = 0, // If key is more complex than 'foo', like 'a[]' or 'a[b][c]', split it // into its component parts. keys = key.split( '][' ), keys_last = keys.length - 1; // If the first keys part contains [ and the last ends with ], then [] // are correctly balanced. if ( /\[/.test( keys[0] ) && /\]$/.test( keys[ keys_last ] ) ) { // Remove the trailing ] from the last keys part. keys[ keys_last ] = keys[ keys_last ].replace( /\]$/, '' ); // Split first keys part into two parts on the [ and add them back onto // the beginning of the keys array. keys = keys.shift().split('[').concat( keys ); keys_last = keys.length - 1; } else { // Basic 'foo' style key. keys_last = 0; } // Are we dealing with a name=value pair, or just a name? if ( param.length === 2 ) { val = decodeURIComponent( param[1] ); // Coerce values. if ( coerce ) { val = val && !isNaN(val) ? +val // number : val === 'undefined' ? undefined // undefined : coerce_types[val] !== undefined ? coerce_types[val] // true, false, null : val; // string } if ( keys_last ) { // Complex key, build deep object structure based on a few rules: // * The 'cur' pointer starts at the object top-level. // * [] = array push (n is set to array length), [n] = array if n is // numeric, otherwise object. // * If at the last keys part, set the value. // * For each keys part, if the current level is undefined create an // object or array based on the type of the next keys part. // * Move the 'cur' pointer to the next level. // * Rinse & repeat. for ( ; i <= keys_last; i++ ) { key = keys[i] === '' ? cur.length : keys[i]; cur = cur[key] = i < keys_last ? cur[key] || ( keys[i+1] && isNaN( keys[i+1] ) ? {} : [] ) : val; } } else { // Simple key, even simpler rules, since only scalars and shallow // arrays are allowed. if ( isArray( obj[key] ) ) { // val is already an array, so push on the next value. obj[key].push( val ); } else if ( obj[key] !== undefined ) { // val isn't an array, but since a second value has been specified, // convert val into an array. obj[key] = [ obj[key], val ]; } else { // val is a scalar. obj[key] = val; } } } else if ( key ) { // No value was defined, so set something meaningful. obj[key] = coerce ? undefined : ''; } }); return obj; }; var avcastUrl = '//www.siteminds.net/m/1.8/mind_rs_prd.php'; // Globals if(!global.avCast) { global.avCast = {}; }; var avCast = global.avCast; // To keep track of which embeds we have already processed if(!avCast.foundEls) avCast.foundEls = []; var foundEls = avCast.foundEls; if(!avCast.calledRS4Once) avCast.calledRS4Once = false; var calledRS4Once = avCast.calledRS4Once; if(!avCast.settings) avCast.settings = []; var settings = avCast.settings; var els = document.getElementsByTagName('script'); var re = /.*mind_loader\.([^/]+\.)?php/; for(var i = 0; i < els.length; i++) { var el = els[i]; if(el.src.match(re) && foundEls.indexOf(el) < 0) { foundEls.push(el); var parameters = parseQueryString(el.src); var d = document.createElement('div'); var container = document.createElement('div'); el.parentNode.insertBefore(container, el); parameters['container'] = container; //console.log('getting '+'blck_callback'+parameters['cast_id']); //parameters['mm_cb'] = 'blck_callback'+parameters['cast_id']; settings.push(parameters); } } // Load main javascript if found some new ones during this script if (calledRS4Once==false) { global.avCast.calledRS4Once = true; //console.log('adding the embed script '); var s = document.createElement('script'); s.async = true; s.src = avcastUrl; document.body.appendChild(s); } }(this));