To expedite your fist visit process, please complete the New Patient Form found below. You can either print the form, complete and bring with you on your first visit or you can follow the simple steps below to send it to us electronically. In the near future, the electronic version will be completed from a form in your browser, we're sorry for any inconveniences while we rectify this problem.
| new_patient_form.pdf |
1. Open new_patient_form.pdf in your web Browser.
2. Save the file to your desktop or file location.
2. Save the file to your desktop or file location.
The down arrow allows you to save the .pdf file to your computer
3. Open with Adobe Acrobat Reader.
Don't have the latest version of Adobe? CLick here.
While in the "Fill & Sign" mode, you will navigate the document from the bottom controls.
4. On the right side to Adobe Reader, click the pencil "Fill and Sign." That reveals a set of editing tools.
5. Clicking on the X you can check boxes.
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or the "Ab" tool to enter text--just click where you want to type and a text box will open for you to fill in.
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6. The "Sign" tool allows you to sign all appropriate places. Just type in your name and drag and drop your signature where needed.
8. Once you've completed the entire form, Click the envelope and send to chw.frontoffice@lvcoxmail.com
