new patients welcome Rockville, MD

For new patients of Dr. Mintz’ practice, you will need to fill out a registration form and a few additional forms prior to your first visit.

To register for the practice, click on “Register for Dr. Mintz’ Practice” below and complete all the information. While we don’t take insurance, we ask for your insurance information for other services you may need, such as referrals or lab work. We also ask for payment information, but will not charge you anything until you choose a payment plan in the office or over the phone.

Register for Dr. Mintz’ Practice

Two additional forms must be completed, and one more if you are over 65. Click each of the appropriate links below, provide all requested information, use your mouse or touchpad to sign your name, and finally click on “submit.”

Acknowledgement of Privacy Policy

Authorization to Release Records

Medicare Policy if 65 and Older

Controlled Substances Informed Consent

If you have any questions about registration or signing forms, please do not hesitate to contact us.