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Click to Print Neuropathy Patient Forms

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At Korman Relief and Wellness Center, we welcome you as a new patient!  We appreciate you considering us to help you on your road to wellness, and we strive to provide you quality, friendly service.

To prepare for your first visit to our office, please print the forms from the link above, answer all questions, and sign each form requesting a signature. (If you feel a question does not apply to you, or does not have an answer, please mark the question as "N/A," or "Not Applicable".)  We cannot start your appointment until your paperwork is entirely complete.  Any delay in our waiting room, due to incomplete paperwork, takes away from your time with the doctor, which we don't want to happen, so please be thorough!

Should you have questions about your paperwork, please call our office, and we will be most happy to help you!

Mail the completed, signed forms to our office prior to your appointment date, or drop them off at our front desk when you're "out and about"!  Completed forms may also be brought to your appointment with you. 

Why Must I Complete All These Forms?

The purpose of these forms and questionnaires is to educate the Doctor about your past health history, as well as the current state of your health.  This enables her to design a treatment plan which focuses on your specific health situation. 

In addition, we need it on file that you give consent to be treated by our office, and that you understand, and agree, that you, as the patient, are responsible for payment.

You also must sign a “ HIPAA” form, which explains your privacy and patient rights. That form will be available for you at our office the day of your appointment.

In order to provide services to you, we absolutely must have these signed, completed, forms in place.  

Should you experience frustration with the online paperwork, please call our office and request the paperwork be mailed to you, or stop by and pick up your paperwork at the front desk, prior to your appointment date.  

We look forward to helping you along your road to wellness!

Dr. Korman, and Staff, at Korman Relief & Wellness Center


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