Wayne A. Hogan DC....... 905 Hudson River Road........ Mechanicville, NY 12118....... (518) 664-5281

 Inch By Inch Health's A Cinch               Yard By Yard, Health Is Hard

                                          

                                Restoring Good Health Is A Process

New Patient Documents

This page contains the documents that we use to establish a new patient case. We realize our forms are comprehensive and ask detailed questions. They help us get the most accurate history of your health. Take your time and answer all the questions. Please allow 15-20 minutes to fill out the forms. We require these forms before your first appointment.

 

To make this process as easy as possible for you, we have provided two ways to submit your information to our office.

Online Submission Forms

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  • Download the New Patient Documents package.

  • This form must be opened with Adobe Reader.  If it doesn't open automatically:

  • Download Adobe Reader using the link below.

  • Click the submit button on the last page.

Your documents will be sent to our office instantly.

You will receive a confirmation email from our office within one business day when we have received them. 

Printable Forms

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  • Download the print version of the New Patient Documents package.

  • Fill out the forms and mail it to our office, or bring it with you to your first appointment.

Use the links below to download the New Patient Documents of your choice.

After clicking on one of the form icons, it will open in a new window. In the new window, simply save the form to your computer.

Use the link for Adobe Reader Free if you don't already have it on your computer.

IN the event you have difficulties with the SUBMISSION process, if you press the Printable Forms button after                                                          you have filled them out "on-line", the completed documents WILL print out!

Please print this 7 Day Diet Diary

 

Knowing what you're eating is important!

Please write down everything you eat and drink. 

Note any symptoms in the margins with the time they occurred.

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