Patient Registration

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature upon arrival. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

If you are under 18 years of age, you will need a parent or legal guardian to be present during the time of your evaluation to sign the Patient Registration Form in our office. A parent or legal guardian must also be present at your surgery appointment.

Online Patient Registration