Forms

Forms Content

New Patients

Child New Patient Packet (under 18)
Adult New Patient Packet (18+)

Your forms must be received by Dr. Archer at least 3 days prior to your first appointment. Please also provide a copy of your insurance card, both front and back.

If you arrive to your appointment without having your paperwork filled out, you will be working on it during your first appointment with Dr. Archer, which will take time away from addressing your concerns.

 

Forms can completed 2 ways:

  1. Use Adobe Reader to fill out the fields on your computer, then save the files to send through email.
    Note – you can legally sign the digital signature areas of the forms, by creating your own Digital ID in Adobe Reader. If you can figure it out, it will save a lot of time, trees, and ink! If you can’t figure it out, you’ll just need to sign in person during your appointment.

    • Click the signature
    • In the “Sign As” menu, select “New ID”
    • Select the new Digital ID option, then the PKCS#12 option
    • Enter your name and email, click Next
    • Set a password for your Digital ID, click Finish
    • You can now use your newly created Digital ID to sign each section (we recommend to wait until all other parts of the form are completed before signing. You’ll probably be forced to save the file each time you perform a signature).
    • Here are more instructions on creating a Digital ID, and using a Digital ID to sign.
  2. Print out the forms and fill in by hand, then either re-scan the forms as PDF files to send through email, or fax/mail/deliver the forms in person.

 

Forms can be submitted by faxing them to (844) 693-1412.