Forms

New patient paperwork

This packet should be completed and sent to us before your first visit:

New Patient Packet

If you are scheduling your first appointment for headaches or migraines with Dr. Klein or Dr. Factor, fill out this packet and send it back to us:

Headache Packet (Dr. Klein’s and Dr. Factor’s new headache patients only)

Dementia Caregiver Form

Caregiver information form

Policies

Records Release Form

HIPAA Form

Financial Disclosure

Financial information for all patients

General Consent for Treatment