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New Patient Paperwork

Our forms are thorough, but Dr. Chalfin reads every one, so we ask that all patients fill out paperwork before their visit so as not to detract from your time with the doctor. Most of our forms are below. Please select the forms that best fits the reason(s) for your visit, print and fill it out, and bring it with you to your first appointment. 
Afternoon Light

Headaches

For patients with head pain, headache, migraine, or similar.

Tropical Leaves

Memory Loss

For patients with cognitive issues -  a reliable loved one to fill this out. 

Plants on the Window

Concussion

For patients with recent head injury/concussion

Snowflake

ADHD

For patients with suspicion of ADHD

Orange Blossom

Tremor

For patients with tremor or Parkinson's or concern thereof

Sunlit Nature Path

Seizures or Spells

For patients who have had a seizure, passed out or black outs. 

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