New Patient?

Register online for:
Fairmont (Here)
Bridgeport (Here)

This online form only takes 5-10 minutes to complete.  You MUST complete this form ASAP to have your appointment confirmed.  If we do not receive this information at least 48 hours (two days) before your appointment, we will release the appointment and notify you that you will be placed on a waiting list.

Or download this document and print