New Patient Intake Forms-2023
I hate filling out forms as much as anyone.  I'm sensitive to digital transfer of personal health information.  

Please know that what you are going to do next IS required in order for Dr Tom Yarema & Associates to service you quickly & confidentially.  This process is in compliance with HIPAA, the federal authority for the confidential transfer of personal health information.  

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jbraye@brayecompleteshielding.com *
Jonah *
Braye *
7723328131 *
Dr Loic Jassy *
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