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Online Forms

Dr. Mitch Ergas offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

NUTRITION NEW CLIENT FORMS - Required

Nutrition New Client Forms

Nutrition New Client Orientation



COUNSELING NEW CLIENT FORMS - Required

Counseling New Client Information Form (Required)

Counseling New Client Consent Form Part 1 (Required)

Counseling New Client Consent Form Part 2 (Required)

HIPAA Privacy Practices (Required)

Counseling Consent & Authorization To Release Information Form

Informed Consent - Minor Child

Client Information - Minor



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Office Hours

Our Regular Schedule

Monday:

Closed

Tuesday:

11:00 am-6:00 pm

Wednesday:

11:00 am-6:00 pm

Thursday:

11:00 am-6:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Locations

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