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New Patient Forms

Come in ready.

Your first visit is a real clinical intake. Filling out the form ahead of time means we spend your appointment on you, not on paperwork.


Before You Arrive

A note from Dr. Cheshire.

The more I know before we meet, the more we can accomplish in our first appointment. Download the intake form, complete it honestly, and bring it with you. Include your history, your current medications, and a clear description of what is bothering you and how long it has been going on.

Do not worry about getting the medical terminology right. Plain language is fine. We will go through everything together when you arrive.

New Patient Intake Form

Download, print, and complete before your first visit. The form opens in your browser, where you can print or save it.

Open and print the form

PDF · opens in a new tab

Cannot print at home? No problem. Arrive a few minutes early and we will have a copy ready for you.

What To Bring

A short checklist.

Ready When You Are

Let us get you scheduled.

Schedule a free 20 minute consultation and bring your completed form along.

Book your consultation 352-430-2720