ADULT REMOTE FOLLOW-UP VISIT

This form is appropriate for patients 18 years of age or older and must be received prior to your appointment.

We request this form be submitted a minimum of one business day prior to the appointment to help give the staff an adequate amount of time to prepare.

Please use the web form below which allows you to fill out & submit directly online.

Please note that you will need to enter pulse and weight. If you have a blood pressure reading from a recent doctor visit or a home BP machine please provide that information.

We must have the form prior to the appointment time.  Without it, Dr. Mason cannot begin your visit. It would be considered a no show and incur a fee.