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New Patient Intake Form

New Patient Intake Form – PDF Download

Preparing for your first appointment with Dr. Wyant:

Before the appointment, please print the New Patient Intake Form – PDF Download and fill in as much detail as possible.  This information will be of help during your assessment, and will also help you organize your thinking about your history.  If there are questions you cannot answer, or do not wish to answer, please feel free to leave those items blank.  After completing the form, please bring it with you to the appointment.  You may wish to make a copy for your own records.