Please Use Your Computer to Complete These Registration Forms
Due to the depth of your health information we capture the forms are not optimizable for completion on a phone or tablet and will interfere with electronic submission.
Functional Medicine Evaluation with Dr. Thomas Rohde
Please complete the following patient registration forms if you wish to be seen for a functional medicine evaluation, including thyroid, hormones, regenerative medicine including joint pain, PRP and Regenerative cell therapy, etc.
This process should take you about 30 minutes.
Traditional Family Medicine, COVID, Cosmetic Procedures
Please complete the following patient registration forms if you wish to be seen for traditional/family medicine, a COVID consultation, or cosmetic procedures like Botox
This process should take you about 15 minutes.
No-Scalpel Vasectomy
Please complete the following patient registration forms if you wish to be seen for our No-Scalpel Vasectomy Procedure.
This process should take you about 15 minutes.
If you prefer paper and pen, you can download our new patient packet using the link below. Completed forms should be returned to our office as soon as possible.
For patients transferring care OUT to another doctor, please print the form below and return the completed document to our office. Download Transfer of Care Form
