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D.C. office:   (240)-778-4568

                              

M.D. office:   (301)-838-0524

                   

                     (240)-778-4568

 

 

DC Location:

529 14th St N.W. #988 

Washington, DC. 20045

 

MD Location:

9075 Shady Grove Ct. 

Gaithersburg, MD 20877

DC Hours:

Mon           11 am - 4 pm
Tue             11 am - 6 pm
 Wed                      Closed
Thurs   11 am - 6:30 pm
 Fri                         Closed
:MD Hours
 
     Mon            12pm - 6 pm
Tues             9 am - 6 pm
Wed           12 pm - 6 pm
Thurs           9 am - 6 pm
Fri               12 pm- 5 pm
Sat               9 am - 5 pm

FORMS: (click on image to see forms)

New Patient Intake Form (everyone)

Consent for Treatment (everyone)

Referral Form (doctor referred patient/ insurance required pre-authorization patient)

HIPAA Form (everyone)
 
Acknowledgement Notice of HIPAA Form (everyone)

HIPAA (record release form)

COVID19 consent Form (everyone)

Work Compensation patients only:

COVID19 consent Form (everyone)

Work compensation Authorization Form                                   (work compensation only)

Work Injury Form  (work compensation only)

New Patient Intake Form 

Consent for Treatment 

HIPAA Form
 
Acknowledgement Notice of HIPAA Form 

HIPAA (Record Release Form)

** Work compensation patients must bring a letter of approval. Information such as case manager, adjuster, company, etc maybe required. Letter of approval needs to have practitioner's name, time and date of approval treatment. Please have all your information ready before delaying of treatments.

**Please read carefully as there are new HIPAA guidelines

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