New Patient Intake
Health history, current concerns, and goals — please complete before your first visit.
Download PDF
Patient resources
Forms & documents
Save time on your first visit. Download and complete these forms ahead of your appointment — or bring them in printed if that's easier.
Downloads
Intake & insurance forms
All forms are provided as fillable PDFs. If you need help completing anything, give us a call at 301-909-8409.
Assignment of Benefits
Authorizes us to bill your insurance directly and receive payment for covered services on your behalf.
Download PDFHIPAA Consent & Privacy
Our Notice of Privacy Practices — how we use and protect your health information, and your rights as a patient.
Download PDFAuthorization to Release Records
Authorize the release or receipt of your medical records to coordinate care with other providers.
Download PDFCancellation Policy
Our scheduling, late-arrival, and cancellation terms — please review before your visit.
Download PDFQuestions about your forms?
Our team is happy to walk you through anything before your visit.
Get in touch