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    • Home
    • About Us
    • Services
    • Your Team
    • Insurances
    • No Insurance?
    • Aesthetic Procedures
    • Forms
    • Contact Us
SynergyMed
  • Home
  • About Us
  • Services
  • Your Team
  • Insurances
  • No Insurance?
  • Aesthetic Procedures
  • Forms
  • Contact Us

Forms & Downloads

New patients, please complete: Registration, HIPAA and Responsibility Forms 

HIPAA Acknowledgement Form (pdf)

Download

Patient Responsibility Form (pdf)

Download

POLST Form (pdf)

Download

New Patient Registration Form (pdf)

Download

Policies

Medication Refill Policy (pdf)

Download

Office Policy (pdf)

Download

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