Please complete and sign electronically BEFORE you or your child visits our office.
Thank you for putting your trust in our office and we are so glad we are able to see you again. This form allows us to screen for communicable diseases including COVID-19 in our office in an effort to keep all our patients and team safe. For each appointment, we will need you to answer the questions below.

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HOURS: Tuesday-Friday 7:00am-4:30pm, closed for lunch from 12:30pm-2:00pm