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Patient Forms

1. Once you have a confirmed appointment date, please download, complete and send us the following PDF forms by email or fax to: michelle@davidwexlermd.com    Fax: (844) 684-8343

 

2. In addition, once you have a confirmed appointment date, please fill out the:

Please note: we do not take insurance. A superbill will be provided to submit to your insurance carrier.

PLEASE NOTE: Our practice is accepting new concierge patients on a limited basis. Please email our office with a brief introduction.

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