LuxSci helps ensure HIPAA-Compliance for email and web services.
Secure Internet Services

For your convenience:

  • Click ONLINE FORM and you will be redirected to a new page where you will fill out the New Person Intake Form online, then press the submit button at the bottom of the form page to submit the form electronically and securely to the office.

or you may:

  • Click PRINTABLE FORM and you will be redirected to a new page where you will:
    1. fill out the New Person Intake Form,
    2. print it and bring it to the office.
    3. Or print the blank form, fill it out and bring the completed form to the office.

 

 

 

If you do not already have AdobeReader® installed on your computer, click the Adobe® image below to download for free.