Helpful Client Forms

If you are a first time patient, please download, review, and complete the following forms found below. I will send you an encrypted email so you can email the completed forms to me through an encrypted email platform. Note: The "Doctor~ Patient Service Agreement"  and "Symptom Checklist" will be encrypted emailed to you.   Please remember, I will also need a copy of your government issued photo identification card or passport, and also credit card to be kept encrypted on file with IVY PAY.  Thank you.

If you would like me to coordinate care with other providers (for example, endocrinologist, psychiatrist, et cetera) then please also complete the form.