New Patient Forms

There is a $25.00 fee for records obtained from our office.
We are able to take this payment online through PayPal.
This can be paid with Visa, MasterCard or a personal PayPal account. After you have completed the release form below you will be redirected to a PayPal site where you will be able to complete your payment.

Records will not be compiled unless this payment is completed.

Payment Links

Please click a doctor below for the appropriate payment link.