Infants and Toddlers. Ages: Birth to 5 years old.
Pediatric Infant and Toddler Paperwork
School Aged Children. Ages 6- 11 years old.
Pediatric School Aged Children Paperwork
Adults, Non-Pregnant. Ages 12 to 100+
Adult Paperwork
Pregnancy
Pregnancy Paperwork
Extensive History Form are for Fertility and Fatigue
PLEASE PRINT and Fill Out! Complete History Form
If using Insurance, Please fill out this Form
Insurance Form
HIPPA– Please Read!
Hippa
What our clients are saying...
Dr. Brenda is AMAZING!! I am a mother of three who struggles with endometriosis pain and most recently a horribly uncomfortable sciatic nerve. For the past two months I have been so uncomfortable no matter what I do I have been unable to get relief nor have I been able to sleep. Yesterday I had an appointment with Dr. Brenda and left there feeling 50% better, woke up this morning and the pain is so dull I hardly notice it!! I am forever THANKFUL to her for helping me and am excited to continue visits confident she will be able to help with the endometriosis as well. Thank You Dr. Brenda from me, my Husband & our kiddos lol..I have been a nice Mama today!!! Laura E.
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