New Patient Forms
New patient forms, made simple.
Two ways to complete each form — fill it out online, or download the English or Spanish PDF.
Step 1 · Before your consultation
Bariatric Questionnaire
A short intake (about 5 minutes) that helps Dr. Perryman understand your health history and goals before we meet.
Step 2 · New Patient Package
New Patient Package
Patient information, insurance, medical release authorization, and practice policies. Takes 8–12 minutes from your phone or computer. When you arrive at the office, we'll spend 2 minutes at check-in to collect your Social Security number and the card we keep on file for the missed-appointment policy.
Option 1 · Secure online
Complete online (8–12 min)Option 2 · Download to fill & bring
You can type your answers right into the PDF on your computer or phone, then save or print and bring it to your appointment.
- HIPAA-compliant intake platform with encryption in transit and at rest
- Card-on-file collected through a PCI-DSS compliant processor — never stored on this site
- We never collect Social Security numbers or full card numbers in fields on this website
- Access limited to authorized clinical and billing staff
Questions about your forms?
Our team is happy to walk you through what to expect.