New Patient Paperwork

for Christine Karell, APRN-BC  and Ana Cerrato-Young APRN-BC

INSTRUCTIONS
Everyone must complete the New Patient Packet.

 

Anyone without insurance that would like to qualify for our sliding fee scale, must complete the Region paperwork and bring required documentation listed with them on their first visit. Please be advised, required documentation must be present at first visit in order to continue with appointment. If documentation is not received in full, your appointment will be rescheduled. 

 

You may complete a Release of Information if you have a specific person or entity you want us to send or receive information to/from. For example, your primary care provider, school, or therapist.  

For all other providers please contact our office and we will be happy to email, mail, or fax you new patient paperwork. 

value. quality care. convenience.