If you would like to save some time at our office, PLEASE fill out these forms before you come in for your appointment. Thank you!

New patient form Updated

New Patient Intake Form. Basic contact information, referral source, insurance information.

New Client Weight Loss / Coaching  Information Sheet

Please fill out the about form if you are having a weight loss, nutrition, Google Helpout or sports training consultation with Dr. Jeff. Please email the form to drjeffbanas@gmail.com



Thank you!