Patient Portal Access

Notice Of Privacy practices
Welcome Letter
Patient RegistrationPlease print and complete the form in its entirety. Please bring the completed form with you for your scheduled appointment.
New Patient Referral FormPlease print and complete the form in its entirety. Fax the information to 570-348-1109 Attn: Donna.
Patient Authorization to Release Medical RecordsPlease print and complete the form in its entirety. Make sure the form is signed and dated. Fax back to office at 570-348-1109.
Medical Records Fee

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