Patient Information Form & Refill Policy

All new patients must complete this two-page Patient Registration FormBring the form to your appointment along with ANY PREVIOUS VACCINATION RECORDS.  Existing patients should also complete this form if they have not been seen at CTM within the last 12 months.

If you would like to send us any personal health information electronically, reply to CTM’s encrypted email which we will send to you upon request.  This ensures that your health information will be kept secure and private. 

Prescription Refill Policy:  Telephone requests for prescription refills will be considered only if we have seen you in our office within the previous 12 months.

Download our Patient Information Form » (2-page PDF)

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