Below you will find our patient forms. Please click links to download and fill out the forms you need.
All new patients must complete the following four forms.
Medical Information Release
For Dr. Klausner to obtain medical records from and or release records to another doctor, please fill out the following form which applies.
Lyme Disease Forms
Below you will find our Lyme Disease patient forms. Please click links to download and fill out the forms you need. All patients currently being treated by Dr. Klausner for Lyme need to fill out the Lyme preappointment patient update form and return to Dr. Klausner at least 3 days before each in person or telephone appointment.
Email Authorization for Medical Records