For your convenience, patient forms are provided below.

On scheduling your initial visit, Dr. Shapiro will instruct you on which form(s) to complete and bring with you prior to your appointment.  Not all patients will need to complete all forms.  Dr. Shapiro could also mail you a copy if you prefer.
notice_of_privacy_practices.drjennifers..pdf
File Size: 60 kb
File Type: pdf
Download File

consent_form.drjennifers..pdf
File Size: 143 kb
File Type: pdf
Download File

authorization.drjennifers.pdf
File Size: 157 kb
File Type: pdf
Download File

intake_form.drjennifers..pdf
File Size: 63 kb
File Type: pdf
Download File

eating__weight_patterns_questionnaire.drjennifers.pdf
File Size: 2621 kb
File Type: pdf
Download File

eating_attitudes_test.pdf
File Size: 87 kb
File Type: pdf
Download File

insurance_form.pdf
File Size: 53 kb
File Type: pdf
Download File

 

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