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Patient Forms

The links below take you to the forms related to your first appointment. Please open, print and complete the New Patient Forms PRIOR to your visit. Bring the completed forms to your first appointment, along with your medical records, referral (if your insurance requires one), most recent medical card, and drivers license. The privacy notice is provided here for your reference only.

• New Patient Forms (33.78 Kb)
• Sleep Disorders Questionnaire ( 40Kb PDF )
• Notice of Privacy Practices  (18Kb PDF - reference only)
• Waiver For Mental Health Benefits (7Kb PDF) - for Dr. Schmalz only

You will need the FREE Adobe Reader to view PDF files.  If you do not have the reader you can download it using the link below.

http://www.adobe.com/products/acrobat/readstep2.html