First Visit Medical Form
Welcome to new patients. We pay special attention to anxious patients.
During your first visit, we must have your medical history. Please fill out the questionnaire at home to have all the information on hand and hand it to us upon your arrival at the clinic. This medical questionnaire is secure and confidential.
STEPS TO FOLLOW AT HOME
- Download the form by clicking here (PDF file)
- Print the questionnaire
- Complete the questionnaire to the best of your knowledge
- Bring the completed questionnaire to your first visit, along with your complete list of medications.
If you forget to fill out the questionnaire or if it is incomplete, it does not matter. However, you are kindly requested to arrive in advance at your appointment to have the time to complete it on site.