Online Forms

New Patient Intake Form - Required Prior to Appointment -

Every New Patient will be emailed a general intake form upon confirmation of your appointment. If for some reason that email did not come through your email provider, please click the link below to access the INTAKE FORM. 

Fill-Out Online Forms


Making Healthy Families.

Sign up using the form below or call (330) 460-5151 to make an appointment.

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Please do not submit any Protected Health Information (PHI).

Office Hours

Monday  

9:00 am - 12:00 pm

2:00 pm - 6:00 pm

Tuesday  

9:00 am - 12:00 pm

2:00 pm - 6:00 pm

Wednesday  

9:00 am - 12:00 pm

2:00 pm - 6:00 pm

Thursday  

9:00 am - 12:00 pm

2:00 pm - 6:00 pm

Friday  

9:00 am - 12:00 pm

Saturday  

Closed

Sunday  

Closed