Everyone must fill out this form on every visit.  It is mandatory.

If you have not filled out this form yet, please do so now

Please fill out the waivers specific to your treatment.

Only fill these out if requested to do so.

Everyone must fill out this form on every visit.  It is mandatory.

If you have not filled out this form yet, please do so now

Please fill out the waivers specific to your treatment.

Only fill these out if requested to do so.