Request an Appointment
Please do not use this form if you have an urgent medical problem or you need to reschedule an existing appointment. Instead, contact the office at (614) 268-2323. After you submit your request, the appointment scheduler will respond within 48 hours.
New Patients: Please see below for forms to complete.
Established Patients: Please use the patient portal to request appointments and update forms.
Patient Registration Forms
Once you have made your initial appointment, you may pre-register by downloading, printing, and completing the forms below. Completing the forms prior to your visit will help speed up the new patient registration process.
Please be sure to bring the forms with you to your first visit, along with any diagnostic films or other test results that may have been ordered or performed by another physician.
- New Patient Registration
- Health History
Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.