We encourage you to fill out the online New Patient Paperwork through the Online Registration Portal below, as it is the most efficient method. Once we access your chart, you will no longer be able to edit any of your information, so having you do the initial entries allows you to state your history in your own words and speeds up the intake process on the day of your first visit.
We ask that you please email us the items below to staff@sparkmanmedicine.com
1. your insurance information (Company name, policy ID, group number, name of Policy holder)
2. medication list (name, dose, instructions)
3. Your preferred pharmacy information.
If you have difficulty with the online forms, you may print out the PDF packet below and fill it out by hand or fill it out on your computer as the form is a fillable PDF. However, to avoid delays at your visit, we ask that you please email us back the filled-out packet to staff@sparkmanmedicine.com so that you do not have to wait in the office for us to enter the data. If you are unable to send the information, please arrive 30 min prior to your appointment to allow us time to enter your data.
As a last resort, we can provide you with paperwork to fill out at your visit. If this is the case, please arrive 45 min prior to your appointment.
You may need to download the form and use Adobe Acrobat in order to fill out and add your signature.