Medical History Form Printable Version
Who should we contact in the event of an emergency?
All information you provide is strictly confidential.
Please note that insurance companies will NOT notify us of any changes to your existing insurance plan. It is your responsibility to provide us with all up to date details of your insurance policy and coverage.
Your appointment time will be reserved especially for you. If you are unable to keep your appointment, please notify us at least 48 hours in advance to avoid a cancellation fee.
We hope that you and your family are well, and our office is again scheduling appointments.
Due to Covid-19 precautions, you must fill out our Covid-19 Wellness Form prior to your visit each time. To prepare for your upcoming appointment, please read our Covid-19 Office Protocols.
Construction for the Broadway Subway has commenced along the Broadway corridor, and we ask that you allow for extra travel time when coming to your appointment.
We look forward to seeing you again soon.