REGISTER ONLINE
 
  • Please fill out all forms as completely as possible. You may then print the forms out and bring them to your first office visit or send to us by clicking on the send button.
  • All forms in box 1 are required. Signatures are required on all forms.
  • Please choose the form that is appropriate for your child's age from box two only.
Register Online
     
    Information Sheet – English /Spanish
 
“Please select and print out the form most suited to your child’s age, complete the form in its entirety and bring to the office on your next visit.
Thank You.”
 
STAYING HEALTHY ASSESSMENTS FOR ALL THE GROUPS
 
English
   
  “STAYING HEALTHY” ASSESSMENT Adolescents, 12–17 years of age
  “STAYING HEALTHY” ASSESSMENT Adults, 18 years of age and older
 
Spanish
   
  CUESTIONARIO "MANTENTE A SU NIÑO SALUDABLE" Adolecentes de 12 a 17 años
  CUESTIONARIO "MANTENGA SE SALUDABLE" Adultos de 18 años y mayores
Request and appointment Renee Patel, M.D. Inc.
Service provided Renee Patel, M.D. Inc.

Physical Examinations

Care for acute/chronic illness

Botox and Juvederm fillers TM

Immunizations

Electrocardiogram, Tread Mill

In house lab and x-ray service

Women to Women clinic by Female Physician

Bone Density Evaluation

Call Us: 301-904-0264 Renee Patel, M.D. Inc.