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    Provided are various forms that require completion prior to your visit. Please download the appropriate form as directed by your physician and/or staff by clicking on the name of the form.

    Please bring the completed form(s) with you to your scheduled visit. This will help expedite the registration process.

    Thank you.

    • New Patient Registration Form
    • Pediatrics Sports Release / Camp Form
    • Authorization to Release Medical Records
    • Health History Form
    • New Patient Registration Form

    Related

    Providers

    Cynthia Howes, RN, CPNP
    Howes, Cynthia RN, CPNP
    Heather Lesage-Horton, MD
    Lesage-Horton, Heather MD
    Valerie Rooney, MD
    Rooney, Valerie MD
    Susan Slowinski, MD
    Slowinski, Susan MD

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    17 Belmont Avenue
    Brattleboro VT, 05301
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    802-257-0341
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