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New Patient Registration Form

   Below are links to the New Patient Registration Form.  You may click on the icons to view the Form in PDF or RTF (Rich Text Format) which is viewable in Microsoft Word or other Word Processing programs.  You need AdobeAcrobat Reader to read and print files in Portable Document Format (PDF).  Click here to download a free copy.

Please fill out entire form and bring to your first appointment with Dr. Bart.

Registration Form