Contact us today.
We ask new patients to open, download, and print the forms below. Please complete these forms and bring them with you to your initial office visit.
Please also bring your insurance card and a government-issued photo identification card.
New Patient Medical History
Click Here to Download the New Patient Medical History Form
Patient Contact Information
Click Here to Download the Patient Contact Information Form
Release of Medical Information
Click Here to Download the Release of Medical Information Form
Patient Financial Policy
Click Here to Download the Patient Financial Policy Form
General Consent for Treatment
Click Here to Download the General Consent for Treatment Form
Patient Testimonials
"The staff here is excellent; you could not find a better doctor or nursing and office staff. You are always treated with the utmost respect. The nursing staff is very informative, and Dr. Daugherty is very caring and compassionate." -- D.C.