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Patient Forms

During your first visit we want to know all about you. If you have had any tests, x-rays or other information be sure to bring them with you. Please fill out the Comprehensive Patient Questionnaire and Patient Registration Form, then print and bring to your appointment.

If any patient information has changed since your last visit (i.e. insurance carrier, address, etc.) please also complete a new form and bring to your next appointment.

Disability Forms

There is a $25 charge for each Disability or Family Medical Leave Act (FMLA) form we complete on your behalf. These forms may be required by an employer, home or auto loan or any other facility that requires disability information. Allow up to five business days to process your request. 		Dr.Butler with patient
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