Patient Intake

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Please click on the link below to download the Patient Intake form. The form can be printed and completed by hand or filled out using Adobe Acrobat Reader. Click here to download the free Adobe Acrobat Reader.

Once form has been completed bring it in or fax it to (760) 325-8814.

Patient Intake Form

Summer Hours
M-F:9:00 a.m.4:00 p.m.
Winter Hours
M-F:9:00 a.m.4:00 p.m.
Sat:9:00 a.m.1:00 p.m.
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