New Patient Limited-Time Special! $50 Consultation and Exam ($145 Value!)

New Patient Form

white pasta on white paper

New Patient Form

Please download the form below and fill it out electronically. You can do so either in your browser or in Adobe Acrobat, which you can download here: https://get.adobe.com/reader/

Once completed, you can save the PDF file and print it out to bring it with you to your appointment, or email it to us at communityclinics@yahoo.com