We have included our NEW PATIENT FORM on our website for your convenience.

New Patient Form

Dr Becker's Office

We recommend that you fill it out on your computer, print the finished form, and bring it to our office on your first visit. You can also print the form and fill it out by hand. If you choose this option please write clearly using black ink.

Filling out the form prior to your visit will save you time when you arrive at our office. If you forget to bring it with you, don’t worry. We have forms that you can fill out here, but please allow adequate time (approximately 15 minutes) for completion.

Please download the Patient form here!

For more information please call us at 206.542.4848 or Email us!