Please print and fill out the appropriate forms and bring them to your first office visit.


Janet L. Shefferly:

Consent To Release Medical, Janet L. Shefferly
Notice Of Privacy Practices
Occupational Therapy Disclosure Janet L Shefferly
Patient Registration Janet L Shefferly
Developmental History Form, Janet Shefferly

 

Sara S. Kemp:

Consent To Release Medical, Sara S. Kemp
Notice Of Privacy Practices
Speech Therapy Disclosure Statement
Patient Registration Sara S. Kemp
Developmental History Form, Sara Kemp



Lora Clements:

Consent To Release Medical, Lora Clements
Noticy of Privacy Practices, Lora Clements
Occupational Therapy Disclosure, Lora Clements
Patient Registration, Lora Clements
Developmental History, Lora Clements