New Adult Patient Forms

All new patients must fill out the following forms and email them to us prior to the initial office visit. If you are not able to do this, then you must come 30 minutes early in order to fill the forms out at the office.

(For example, if your appointment is at 9:30am, you must arrive by 9am in order to fill out the forms)

Instructions on how to fill out forms: Please note that there is a Word Doc format and PDF format below for you to choose from. Click on the arrow icon on the top right of the document below to open it to a new window. In the black navigation bar at the top right, save the file on your computer, then open the file with the appropriate Word or PDF software. Once complete, save and email to staff@droharaclinic.com, or bring the form with you to the office at least 30 minutes prior to your appointment time.

WORD DOC format below:

New Pt Registration Adult.docx

PDF format below:

New Adult Pt reg + consent Final.pdf