Patient Information

Download Patient Forms

To view the forms listed below, you will need to download Adobe Reader.

In order to make our initial consultation most effective and efficient, please accept our invitation to create your patient portal account with Charm Patient Portal, and fill out the questionnaire and intake forms. It is a HIPAA compliant method to deliver patient information securely.

If you encounter technical difficulties, you can alternatively download and fill out the forms to the right.

Consultation appointments may be cancelled if the intake paperwork in its entirety is not submitted within 48 hours of an initial consultation without discussing it with the clinic in advance.

Please note that in addition to the initial New Patient paperwork, you must review, and consent to the financial agreement and Credit Card Authorization forms.