Patient Intake Form

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All new patients will need to fill out the Online Patient Registration Form and printable Patient Intake Forms unless otherwise instructed by our front office staff.

Printable Intake Forms

After you fill out the Online Patient Registration Form, please print and fill out these Intake Forms. If you do not have access to a printer, please come in at least 10 minutes prior to your scheduled visit, and you can fill out the forms at Avant PT.

1. • Patient History
   • Procedures and Financial Policy
   • Notice to Patients