Patient Forms

In order to prepare for your visit, please download all relevant forms.

Downloading all necessary forms and filling them out prior to your visit will help expedite your appointment. If you do not have the latest version of Adobe Acrobat Reader, you may download it here.

Palisades Office Forms

(Dr. Desmond, Dr. Gavarre, Dr. Sincoff, Dr. Galligan-Campbell)

New Patient History Form
New Patient History Form (Under 18)
New Patient History Form (Spanish)
Records Release Form
FAQs for Remote Scribe
Consent for a Remote Scribe
Consent for a Remote Scribe (Spanish)

Chapel Office Forms

(Dr. Theis, Dr. Marcus)

Adult New Patient Form
Pediatric History Form
Patient Registration and Financial Policy
Records Release Form

Stowell Office Forms

(Dr. Okerblom, Dr. Jezierski, Dr. Garcia)

Heart Healthy Diet
Patient Registration and Financial Policy
Records Release Form

Shepard Office Forms

(Arain)

Patient Registration and Financial Policy
Records Release Form

Daniel Office Forms

(Desai)

Patient Registration and Financial Policy
Records Release Form

General Forms

Our Offices

Palisades Office Chapel Office Stowell Office Shepard Office Daniel Office

Health Tips

To control your cholesterol, get a cholesterol screening, eat foods low in saturated fat and cholesterol, maintain a healthy weight, exercise regularly and follow all your healthcare professional’s recommendations.

Cholesterol can be both good and bad, so it’s important to learn what cholesterol is, how it affects your health and how to manage your blood cholesterol levels.