MMJ Patients – Please fill out the appropriate forms before your first visit then bring the completed forms to your appointment.

All other patients – we will need to receive your completed intake forms at least one working day before your first appointment. (By Tuesday if your appointment is on Thursday, by Thursday if your appointment is on Tuesday)

Current Patient: MMJ INTAKE FORM

New Patient: Medical Marijuana (MMJ) INTAKE FORM + privacy acknowledgement

Dr. Rav Ivker
Choose the appropriate form:
Sinus Health History
General Health History
Asthma Health History
Asthma Sinus Health History

Fully Alive Privacy Policy:
FAM HIPAA Notice of Privacy Laws