Directions

New Patient Forms

 
     
 
lefttop
 

 

New Patient Forms

 

 

New Patient Form- Click Here

Directions to Submit

1. Upper left hand corner click on "Click to Submit"

2. "Select E-mail Client"

3. If you use Microsoft Outlook or a similar desk top email click on the first option.

---Click OK

---Your E-Mail will be brought up, then click on send mail.

4. If you use Gmail, Hotmail, Yahoo or any other internet based email, click on option 2

---"send PDF Data" window will pop up. Choose where you want to save the file and click on save.

---Open your Email.  Attach the file and send to AAISEMI@comcast.net

 

Or- print and bring with you to your visit.

 

 

 

 

 
righttop