Please print and complete the forms below for your first appointment,
or arrive 20 minutes prior to your scheduled time to complete them at our office.
Intake and HIPPA Forms to Print
General Pain Scale
These forms are for specific concerns:
Designation of Personal Representative
Horowitz Lyme Questionnaire
Everyday Memory Questionnaire
Headache Disabilty Index
Symptom Impact Questionnaire
Fibromylagia Impact Questionnaire (FIQR)
Our physician will meet with you to review your health history, medical conditions and medications and prescribe HBOT if is appropriate for your situation, or your physician may provide a prescription for you.