This downloadable pdf form is for you to print out and fill out before your first visit. This information is confidential and will not be shared with anyone. I need to know of any particular medical conditions that may affect the type of treatment we decide upon for you. It is also useful to know if you have any specific problem areas you would like for me to target.
For interior views of the office, please click here.
NC license #2417 Charlotte Duke Englehart, LMBT
NC license #2417