Medical History Form

First Time Patients

First time patients will have to fill out a medical history form before seeing Dr. Betty Bai for their initial assessment. This form asks for information such as:

  • Patient Contact Information
  • Emergency Contact Information
  • Medical History
  • Current Diagnosis and Health Conditions
  • Patient Informed Consent

For your convenience, you may print and fill out our Medical History Form prior to your appointment time to better prepare for your visit. [Click this link to download the Medical History Form]