Intake & Consent Forms

Please print and complete the following intake forms and bring with you to your initial office appointment.

NPP and Consent Form (5 pages)

IFM Intake Form (female at birth)

IFM Intake Form (male at birth)

Notice of Privacy Practices

Click here to view our privacy practices. A physical copy may be requested at the time of your office visit.

Requesting Laboratory Reports

You may call the labs directly to request a written copy of your results or view/print via their online portal.

• Quest Diagnostics:

• IgeneX: 800-832-3200

• Genova Diagnostics: 800-522-4762 & online portal

• Real Time Labs: 972-492-0419

• PCI (Parasitology Center Inc): 480-767-2522

• Microbiology DX: 781-276-4956

• Moleculera Labs: 405-239-5250