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Patient Registration Forms

I have added convenient registration forms so that you may pre-register more easily.

Click on the following links to fill out the forms.

Patient Registration Form     

Office Policy and Disclosure Statement     

Credit Application Form     

Information Release Form     

Coaching Agreement     
This form does not apply to therapy patients.


This website and all contents are copyright protected © 2008 Bonita Quiroz-Cantu

 

The great thing is the start - to see an opportunity for service, and to start doing it, even though in the beginning you serve but a single customer - and him for nothing.

Robert Collier