Health History Form

Please complete the health history form below and either submit or email the completed form to Dr. Bray ( at least 48 hours before your first scheduled appointment.

NOTE: while we are not able to save your work on this page, you may print or email the form to/for yourself by using the print and email icons at the bottom of this page. You may also complete the form piecemeal by submitting multiple portions of the form at a time. If you do this, please do ensure you provide your name, email address, and phone number with each submission.

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