To schedule an appointment, please call 740-689-9860
If you are a new patient, please fill out the New Patient forms listed below in advance of your appointment to assist the staff in making sure that we have all the information necessary to provide you with quality care and treatment. Please bring the completed forms with you to your appointment along with your insurance card(s), copay, current medications, vaccination records and custody paperwork if applicable.

New Patient Forms - Adults

Demographics - Adult - ages 18 & up
Financial Policy
Adult Health Questionnaire - ages 18 and up
Medical Records Release- Adult

New Patient Forms - Minors

Demographics - Pediatric - ages 0 - 17
Financial Policy
Adolescent Health Questionnaire - ages 7 - 17
Pediatric Health Questionnaire - ages 0 - 6
Medical Records Release - Minor - ages 0 - 17

Patient Rights & Responsibilities

We respect our patients’ dignity and pride. This document will explain your patient rights and responsibilities. It is part of your patient registration and is an important part of your health care plan.
Practice Policies & Patient Responsibilities
Vaccine Policy

Privacy Notices

This privacy notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Notice of Privacy Practices (provided for you at your first visit)

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