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DR. ROY PETRAS
DR. DENNIS PETRAS
DR. SANDRA FREDERICK
165 Sandwich Street South
(1) Please click on and download our New Patient forms:
Please note: The insurance coverage information is optional. Due to privacy laws, some insurance companies will only provide our staff members with minimal or no information regarding your plan. You may follow the instructions on the form if you'd like to provide our office with the most accurate details on your plan.
2) Open up the PDF using Adobe Reader
(download free Adobe Reader program at: https://acrobat.adobe.com)
3) Complete forms in one of two ways:
a. print out the forms, fill out in pen, and bring with you to your first appointment.
b. fill out forms in Adobe Reader, save a copy to your hard drive, and email as an attachment to firstname.lastname@example.org
Thank-you for helping us efficiently handle your initial appointment!
Any above issues can be brought to our attention via phone (519-713-8985) or email to email@example.com, and we would be more than happy to assist you!
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