Below are links to our deployment exam demographics form and history form.   Please fill out both forms completely and make sure you received confirmation of submission.  Please also upload a copy of a government issued ID for the patient (if the patient is a minor, upload a copy of the ID for the parent or guardian).  ID is required for all services.

Regarding the security of these forms:  Click here to find our more about how we secure the information you submit online.

Please make sure you fill out both forms and complete all steps.

Step 1

Deployment Exam Demographics Form

Step 2

Deployment Exam Medical History Form

Step 3

Upload image of ID HERE