New Patient Form

Once we have scheduled a first appointment, please fill out this form and email or fax it to me at least 24 hours before our appointment.  I will then send you instructions for our Zoom meeting.  This form must be completely filled out and signed before we can have our appointment.  My email is secure and encrypted:

 

  barnes@sbarnesmd.com

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In order to fill out and save the above PDF, you'll need the latest Acrobat Reader.  You can download Acrobat for free here:  http://get.adobe.com/reader

700 Garden View Court

Suite 201-C

Encinitas, CA 92024

Shawn Barnes M.D.

Tel: 760-487-8344

Fax: 307-242-1069

barnes@sbarnesmd.com