New Patient Questionnaire

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Step 1 of 8

We request all new patients complete The New Patient Questionnaire.  Please click Next at the bottom of the page to complete the online form.

Important Instructions

1) You may need to disable ad blockers on for proper function. No ads or tracking are contained in the New Patient Questionnaire.

2) If you want to pause and restart at another time, please click the “VERY IMPORTANT…” link at the bottom of this page.

3) For your benefit, please fully answer all questions, as the basis of your analysis is a detailed medical history.

4) We respect your privacy. Your New Patient Questionnaire is hosted on our private secure server. No information is given to outside parties, nor is it stored in the so-called cloud.