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Liverpool: 315-325-2020
Fayetteville: 315-625-2020
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Home » Patient History Form

Patient History Form

For a printable form click here

 

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Important Insurance Changes
We have updates in our office procedures, technology we are using to keep you safe, and insurance changes. Please check our “Doctor’s Announcement During the COVID-19 Outbreak” for more details and to see Dr. Malara’s update video. Follow this link to see if the insurance changes will affect you.