3307074482
Patient Intake Form
Assignment and Release Form
INFORMED CONSENT AGREEMENT
NOTICE of PRIVACY PRACTICES - ACKNOWLEDGEMENT & CONSENT
STANDARD AUTHORIZATION OF USE AND DISCLOSURE OF PHI
Disclosure of Fees/Payment Policy
Secure File Transfer
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8:30 am-5:30 pm
Tuesday:
9:00 am-12:00 pm
Wednesday:
Thursday:
Closed
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Saturday:
Sunday: