Use the links below to download all forms:

Be sure to fill and sign all 8 forms. If you have any questions feel free to give us a call!

Remember:

  • Bring a list of your current medications

 

ALL PATIENTS MUST FILL OUT FORMS 1-5.

1.Patient Registration

2. Patient CC Information

3. Patient Intake

4. HIPPA Agreement

5. Practice Policy Agreement

 

 * Complete this consent for ONLY if receiving any form of Ozone Therapy including Chelation/Prolozone

 Ozone Informed Consent

 

 

 

 

* All therapies are MD ordered and supervised and RN administered in the state of NY