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Waterford Office: 860-442-0407
Waterford New Patient Forms
Mystic Office: 860-536-3078
Mystic New Patient Forms
After Hours (Emergency Only)
860-437-4771
Forms
To open the file, click on the link below. To save to your computer, right-click (windows) or ctr-click (mac) and save the file. You will need Adobe Acrobat Reader installed to download and view the files.
(Click here for the free download).
Patient Forms.pdf Download, print, complete and bring to your office visit. Please complete if you have not been seen in our office for over 2 years or are a new patient.
Dizzy questionnaire.pdf
Download and fill out this form if you are experiencing dizziness.
Snoring and Sleep Apnea questionnaire.pdf
Download and fill out to help the doctor determine the severity of your sleep disturbance.
Hearing Aid Drop-Off Form.pdf
Download, print, fill out and bring when dropping off a hearing aid for service.
Request for release of records.pdf
Print and fill out if you need to request records from our office.
Credit Card Authorization Form.pdf