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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)
HIPPA Form (everyone)
Acknowledgement Notice of HIPPA Form (everyone)
HIPPA Signature Form (everyone)
Work Compensation patients only:
Work compensation Authorization Form (work compensation only)
Work Injury Form (work compensation only)
New Patient Intake Form
Consent for Treatment
HIPPA Form
Acknowledgement Notice of HIPPA Form
D.C. office: (240)-778-4568
M.D. office: (301)-838-0524
(240)-778-4568
Location
DC Office:
1010 Vermont Ave. N.W. #501 Washington, DC. 20005
MD Office:
9075 Shady Grove Ct.
Gaithersburg, MD 20877
DC office:
Mon 11AM-4PM
Tue 11AM -6:00PM
Wed Closed
Thurs 11AM- 6:30PM
Friday Closed
Satur Closed
Sun Closed
MD office:
Tues 9:00AM - 6:00PM
Wed 9:00PM - 6:00PM
Thurs 9:00AM - 6:00PM
Friday 12PM- 5PM
Sat 9:00AM - 5:00PM
Sun Closed