New Patient Forms needed (age sensitive)
If you have current x-rays or records please complete this form so that we may obtain your
records prior to your appointment. Some offices require several days to a week notice to
forward your records so please do this in advance, if possible. This will allow for your records
to be available in our office on the day of your appointment.
Release of records to Dr. Rouse
You may print this form for your records and information only (if desired):