Save time before visiting our office by downloading and filling out the forms below.

 

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NOTICE OF PRIVACY PRACTICES
Notice of privacy practices.pdf
Adobe Acrobat Document 258.8 KB
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HIPAA Consent Form
HIPAA Consent.jpeg
JPG Image 335.4 KB
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Patient Information
Patient Information 2020.jpeg
JPG Image 314.5 KB
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RECORDS RELEASE FORM
recordreleaseje.pdf
Adobe Acrobat Document 296.9 KB
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Patient Medical History
Patient Medical History 2020 (2).jpeg
JPG Image 425.8 KB
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Office Policies Page 1
office policies-page-001.jpg
JPG Image 291.8 KB
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Office Policies Page 2
office policies-page-002.jpg
JPG Image 236.5 KB
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Email Waiver
Email Waiver 2020.jpeg
JPG Image 240.1 KB
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Dr. Magdalena Spiewak

Lic# 270A 00638000