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New & existing patients

Patient forms

Standard forms will be requested via email prior to your appointment. Additional forms are located below.

Download and complete before your visit to save time at check-in. If you're not sure which ones you need, call us at 203-318-6143 and we'll walk you through it.

1. Notice of Privacy PracticesPDF↓
2. Authorization for release of medical informationPDF↓
3. Telehealth consentDOCX↓
4. Credit card authorizationDOCX↓
5. Patient specialist formDOCX↓
6. Consent for treatmentPDF↓
7. Financial policyPDF↓
8. Language servicesPDF↓