New Patient Forms
New patients: please download and print all five (5) pages. Please complete and bring with you to your appointment.
Sponsorship and Advertisement Request Forms
Lemak Health considers all sponsorship and advertisement requests. Upon review, our marketing department will contact you if we are interested in your request.
Patient Referral Form
To submit your referral request please complete the Patient Referral Form and fax to the appropriate clinic, along with any relevant patient clinical information and a copy of the patient’s insurance card. If you have any MRI or X-ray information, please provide or instruct your patient to bring to their appointment.