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Weight In Gold
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Health History Questionnaire

 Get ready for your first appointment! 

Completing this form beforehand lets us tailor your initial visit for a smooth and efficient experience. 

The information you provide in this form will be kept confidential and secure, following HIPAA regulations. It will only be used by authorized healthcare providers involved in your care, and will never be shared with any third parties without your consent.

New Patient Health History Form (pdf)

Download

Pediatric Patient Health History Form (pdf)

Download
press here for the online health history formPress here for the online pediactric health history form

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