There is a standard service charge of $15 for any form completion ($50 for expedited service – same/next business day if the physician is in the office). This amount is due at the time the forms are submitted to our office. Please allow 5-7 business days for processing.  The forms will be sent to you in a password protected PDF with a six digit numerical code (no slashes).  For example- if your child’s date of birth is January 15, 2003 the code will be 012003.

Please download any of the following forms as needed:

Registration Form and Insurance Information


Assignment of Benefits Form

Office Policy on Insurances and Payments

Lab Fee

Late/Missed/Cancelled Appointment Policy

Delegation of Consent


HIPAA/Prescription Consent Form

 Assignment of Benefits Form

 Credit Card Form

We will be open this Saturday the 18th but will be closed Monday, the 20th, for Martin Luther king day.