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You can save time in our office by filling out your patient questionnaire form from the convenience of your home. Simply download the form below, complete and bring it with you.
New Patient Questionnaire Form
Note: This file is in PDF format. If you do not have Adobe® Reader® on your
computer, you can download it for free by clicking here or on the Get Adobe Reader icon. |
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You will be seen personally by Dr. Washton for the initial consultation--to evaluate the nature and extent of your alcohol/drug use and related problems—and to formulate an individualized treatment plan. Once you have set up an appointment with Dr. Washton, please download, print out, and fill out the New Patient Questionnaire and bring this form with you to the appointment.
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