New Client Forms‎ > ‎

Consultation Form- Paper

Welcome New Consultation Clients!

Please print out and complete the Consultation Policies Form at the bottom of this page to expedite your visit. 

Bring To Your Appointment

  1. The Completed Form 
  2. Driver's License or Government ID 
  3. Health Insurance Cards 

How To Print The Form 

A link to the form is at the bottom of this page. Click on the form's name to open it directly, then print it out. Or click on the downward arrow to the right of the form's name to download it. Then open the form, and print it out.

If the form does not open automatically you may need to download the free Adobe Reader here.

If the form does not look properly formatted on your screen, try downloading the form to your computer, and then opening it with Adobe Reader to print it.

If you prefer, you may request the form to fill out at the time of your visit.

Dr Diak will review the form with you during your session.
Frank Diak,
Jun 25, 2016, 9:34 PM