New Patient Paperwork

Christina Kulesz, D.C. offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring the necessary form(s) to your appointment.

**Most major insurances accepted**

  • New Patient Intake Form

    Click to Download

  • Informed Consent Form

    Click to Download

  • HIPAA Health Care Authorization Form

    Click to Download

  • Financial Policy (non MVA)

    Click to Download

OFFICE HOURS


Monday
Closed


Tuesday
8:00am - 6:00pm


Wednesday
8:00am - 6:00pm


Thursday
8:00am - 6:00pm


Friday
9:00am - 5:00pm


1st & 3rd Saturday
10:00am - 2:00pm

Christina Kulesz, D.C.

46B Batavia City Center
Batavia, NY 14020

(585) 344-1682