Please review and fill out these forms then click "submit". A prompt will let you know that the forms have been submitted properly. We look forward to seeing you!
It is important to "submit" the forms instead of printing them yourself. If you print them and bring them in, it may result in having to to re-do the forms.
- Patient Info Form
- PCP Release
- General Release (For anyone other than your Primary Care Physician)
- Pharmacy Intake
- Intake Questionnaire
- Financial Agreement and Worker's Compensation/No Fault
- Privacy Notice and Confidentiality Agreement
- Consent for Treatment (Required ONLY if you are seeing a Medical Provider)
- Intake Questionnaire (For New Patients of Kenna Burns ONLY)