Dr. Leah McNeill - New Patient Forms

The doctor of the
future will give
no medicine, but interest his patients
in the care of the
human body,
in diet, and
in the cause and prevention of
disease."

~ Thomas Edison ~

New Patient Forms

*Print, complete, sign and date the appropriate forms.
Then bring with you for your first visit along with your insurance card and driver's license.

Note: The Patient Privacy Policy is provided in this link HIPPA Privacy Policy.
It is provided for your review online or to print if you wish to retain a hard copy for your files.
You do not need to bring with you.

We request you print these forms SINGLE-SIDED only.
Please do NOT print double-sided.

Intake and health history...[these forms are for patients age 14 and older]

Pediatric intake and health history...[these forms are for patients UNDER 14]

The forms require Adobe Reader or other PDF reader. If you need to install Adobe Reader,
it is available to download and install free of charge at the following link.