Below are some patient forms and informational handouts for your convenience. Click on a form’s title to download it, and do not hesitate to contact us if you have any questions.
(Note: To view the forms listed on this page you will need to have the Acrobat Reader software installed on your computer. If you don’t already have it you can download it here. If all goes well, it should install easily and quickly.)
For All New Patients:
Before your first visit, please download the Patient Intake form and the Patient Symptoms Checklist forms below, print them and fill in all of the information requested. Sign and date the Patient Intake Form, and if you have an email address please be sure to include that so Dr. Chelson will be able to send you any information and announcements you need to receive going forward.
You may fax or email these forms before your visit, or just bring them with you. Please write legibly, so your answers will be received clearly if faxed. (520) 722-1904.
FORMS and HANDOUTS
- Patient Intake Form
- Patient Symptoms Checklist
- Rates and Payment Policies
- To Do List for First Visit