Become our patient

Dear prospective Greenlighter,

You may fill out the following forms by either printing them out and filling them in by hand or by clicking on each box to type in your answer. You may then bring the completed forms into our office for your first scheduled appointment or send the forms in before your appointment via email to our office manager, Peggy Paulo at peggyatwilkins@aol.com  or fax at, (203) 531-7449.

Thank you.

Download Forms:

• New Patient Form
• Initial Assessment Form
• Medical Release Form
• Payment Policy