patient forms
It is always our goal at Dr. Simon Becker DPM to give you the medical care you deserve in a timely manner. In order to ensure that your first visit goes smoothly, you may want to complete the forms below prior to your visit. You can even fax us your forms or drop them off prior to your appointment to speed up your first visit.

Welcome Form – Download & Print Form

Privacy Notice Receipt – Download & Print Form

Financial Agreement – Download & Print Form

Privacy Notice – Download & Print Form

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