New Patient information

It's a LOT better to fill this form out at your leisure than trying to cram them in at the beginning of a visit - take your time - give us more rather than less ( spelling is NOT graded !!)  If the doctors feel you would be more efficiently seen by a different type of doctor, we will advise you because we can tell with this information, if we are going to make a difference. 
Please plan on spending at least 1.5 hours in this visit. The exam rooms are small, please limit the number of people you bring to the absolute minimum  - if possible, place other children with alternative care so you may - we are under severe waiting room restrictions.   Feel free to bring a recording device if there are other family members who want to hear what is said.Make plans to be here a bit early - if you are late, we may have to reschedule - no kidding.



This is an expandable box for an essay. Take your time - unload everything about your concerns and the expected result of being seen and evaluated.   We are after what the FOCUS of the visit should be, a priority list ( #1 problem, #2 Problem # 3 etc) .  For this emergency time, we may be able to analyze your case and order your lab work before you physically come in to the office.  Let us know if you want to exercise that option. 

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bother you *
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Does your heart *
Heartburn or reflux? *
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