Become a Patient

To become a new patient please complete the following forms as appropriate and return them to our office. We also request that you submit the “Authorization to Use and Disclose PHI” form to your previous physician to have your records transferred to our office prior to your first visit.

Please call our office at (978) 577-0437 to schedule an appointment for your child.

Forms may be printed at home and brought to your appointment.

Registration Form (online version)

Registration Form (print version)

HIPAA ~ Acknowledgement Form Minors

HIPAA ~ Acknowledgement Form 18+

Authorization to Use and Disclose PHI

Patient Consent for MASS HIWAY

The MASS HIWAY: Fact Sheet for Patients