Patient Information

Patient InformationIf the patient is taking medication for another condition or has specific allergies, we need to know before beginning treatment. We can accommodate the patient’s needs and help ensure their treatment is effective. We can also make changes to the treatment when necessary. With this information, we can also keep the information in our records for reference during future appointments.
Patient PortalTo fill out the Telemedicine Consent form, click the button below. Once completed, email the form to [email protected]
Telemedicine Consent Form

Second Location293 Passaic Street

Passaic, NJ 07055
Hours of Operation:

Monday & Friday: 8am-4pm 

Wednesday: 10:30am-7pm 

Every Other Saturday: 9am-1pm 
Request An Appointment

First & Last Name (Required)

Email (Required)

Phone Number (Required)

Select an Option

First & Last Name (Required)

Email (Required)

Phone Number (Required)

Select an Option

New Clients

By gathering information on the patient’s current condition and medical history, we can customize the treatment to their needs.

Second Location

New Clients

Payment Methods – Cash or Credit Accepted