Plan Your Visit

Consent Form and Intake Form Checklist

Before you begin filling out the these forms, please check off below that you have the following available:

A digital scan or photo of the front of your drivers license. A digital scan or photo of the front of your drivers license. Yes, I have.

A digital scan or photo of the back of your drivers license. A digital scan or photo of the back of your drivers license. Yes, I have.

A digital scan or photo of the front of your insurance card A digital scan or photo of the front of your insurance card Yes, I have.

A digital scan or photo of the back of your insurance card. A digital scan or photo of the back of your insurance card. Yes, I have.

I have 10 minutes to complete the consent form. I have 10 minutes to complete the consent form. Yes, I have.