203 Main Street

Freeport, ME 04032

(207) 865-1203

(207) 865 -4422 fax

                  New Patient Forms

Please download and fill out the appropriate forms before your visit.  You can download them in word or in a PDF.

New Patient Letter                  PDF       

Health History Form              PDF         

Women's Form                          PDF

Children's Form                        PDF

Personal Information                PDF         

Consent to Treatment            PDF        

Notice of Practice Privacy     PDF 

If you can't download the forms on PDF you need the latest adobe reader.  It's free just click here.