New Client Form
In order to get scheduled for a consultation, we do ask all new clients to fill out the form below. Once completed, we will reach out via phone to set up an initial appointment.
Click the Link to fill out the form:
https://intakeq.com/new/eduqiz
Release of Information
If you are a current client looking to fill out a release of information form to allow family members or other physicians access to your medical records, click the link below to fill out the form.
Note: If you have a child 13 years or older and wish to help them schedule their appointments, we do require an ROI on file.