New Patient Forms

Please click to download forms for a specific doctor:

Charles Lennon

• Patient Information / Consent for Services
• Consent for Use and Disclosure of Health Information (This form is a HIPPA form which reserves your privacy and allows the doctor to discuss your information with another physician).

Harold Gelb

• Patient Information / Consent for Services
• Consent for Use and Disclosure of Health Information (This form is a HIPPA form which reserves your privacy and allows the doctor to discuss your information with another physician).
• TMD form
  

Jason Wallman

• Patient Information / Consent for Services
• Consent for Use and Disclosure of Health Information (This form is a HIPPA form which reserves your privacy and allows the doctor to discuss your information with another physician).

Michael Gelb

• Head Neck and Facial Questionaire
• Sleep Questionaire
• Consent for Use and Disclosure of Health Information

Michael Lenchner

• Patient Information / Consent for Services
• Consent for Use and Disclosure of Health Information (This form is a HIPPA form which reserves your privacy and allows the doctor to discuss your information with another physician).

Robert Schulman

• Patient Information / Consent for Services
• Consent for Use and Disclosure of Health Information (This form is a HIPPA form which reserves your privacy and allows the doctor to discuss your information with another physician).

Sathya Kallur

• Patient Information / Consent for Services
• Consent for Use and Disclosure of Health Information (This form is a HIPPA form which reserves your privacy and allows the doctor to discuss your information with another physician).