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Teresa Yin Wong, DC
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To save time, you may print these forms, complete them before your appointment, and bring them with you. 

Patient Registration Form

Initial Problem Report

Patient Health History

Notice of Confidentiality and Privacy Practices

Informed Consent for Chiropractic Treatment and Care

Privacy Practices Acknowledgement

Consent for Use and Disclosure of Health Information

 


These forms are in Adobe's Portable Document Format (PDF). If you do not have the Adobe Acrobat Reader installed on your system, you may download it for free from Adobe's website.

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