Documents and Forms

NEW PATIENTS: Please complete the following forms:

  1. Office Policy Form

  2. Adult or Child Intake Forms

  3. Adult or Child Consent Form

  4. Release of Information Form (ROI)

Please email or fax them to Dr. Chico for his review before your first appointment.

Office: 410-828-0103

Fax: 410-828-0102

Email: aachico3@gmail.com

1. Office Policies Form
2A. Adult Intake Form
2B. Child Intake Form
3A. Adult treatment Consent Form
3B. Child Treatment Consent form
4. Release of Information Form (ROI)