Light & Information Medicine

New Client forms

Please print out and sign these forms. Bring these with you to your appointment. If you're scheduling a telehealth visit, please email these back to me prior to your scheduled appointment:

Please save this form to your computer or phone, fill it in, save and email back to me PRIOR to scheduling your appointment.

Optional: Horowitz Lyme-MSIDS (save to your computer and fill-in, save again and email)