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All services are performed by appointment. In order
to make your time special, please call in advance so that we may
schedule a time convenient for your needs. Walk-ins may be accepted
if time allows.
We make every effort to be on time for our patients
and we ask that you extend the same courtesy to us. Should an emergency
arise that prevents us from seeing you promptly, every effort will
be made to notify you as soon as possible.
In the event that you are unable to keep your appointment
or need to reschedule an appointment, we ask that you kindly give
us advance notice.
Welcome to our office!
Please fill out the following forms (A and B) as
completely as you can and read the Financial Policies and Notice
of Privacy Practices for Protected Health Information (C and D).
Return the completed forms prior to your first appointment, so that
we may attend to you sooner on your first appointment. You may return
these forms via fax (937) 754-4575.
A. Patient Information Sheet
 Patient.pdf
(20k)
Patient_fill.pdf
(65k)
B. Health Questionnaire
Health.pdf
(24k)
Health_fill.pdf
(356k)
C. Financial Policies
Financial.pdf
D. Notice of Privacy Practices for Protected
Health Information
HIPPA.pdf
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