For a faster and more efficient service, please complete the online form below and send it by email and / or print and bring to your first visit. This first visit medical form provides all relevant information about your health. Rest assured of our full confidentiality.

Please fill out the medical forms below (click below)

Adults form
Children form
Financing Politics
Easy payments with Visa, MC, or Bank card. A no-interest long term payment plan may be available.