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NEW PATIENT HEALTH HISTORY FORM
NEW PATIENT HEALTH HISTORY FORM
NEW PATIENT HEALTH HISTORY FORM
In order to provide you the best possible care, please complete this form and bring it to your first appointment. Along with your insurance cards and license. All information is strictly CONFIDENTIAL
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Sandusky Location
OFFICE OPERATION
Monday 08:00 AM - 04:30 PM
Tuesday 08:00 AM - 04:30 PM
Wednesday CLOSED
Thursday 08:00 AM - 05:30 PM
Friday 08:00 AM - 04:00 PM
Saturday OPEN
Sunday CLOSED
**Open most Saturdays, but please call ahead to check availability and schedule an appointment.
Huron Location
OFFICE OPERATION
Monday 8:30 AM - 5:00 PM
Tuesday 9:00 AM - 5:30 PM
Wednesday 8:30 AM - 4:30 PM
Thursday 8:00 AM - 4:00 PM
Friday CLOSED
Saturday OPEN
Sunday CLOSED
**Open most Saturdays, but please call ahead to check availability and schedule an appointment.
Clyde Location
OFFICE OPERATION
Monday 8:30 AM - 4:30 PM
Tuesday 8:30 AM - 4:30 PM
Wednesday 8:30 AM - 4:30 PM
Thursday 8:30 AM - 5:30 PM
Friday CLOSED
Saturday OPEN
Sunday CLOSED
**Open most Saturdays, but please call ahead to check availability and schedule an appointment.
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