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New Patient Paperwork

You will receive an email link from Elation, our electronic medical records (EMR) system, to complete your new patient paperwork online. Our forms are thorough, but Dr. Chalfin reads every one, so we ask that all patients fill out paperwork before their visit so as not to detract from your time with the doctor. Instructions for completing these forms are located here.
If you have difficulty submitting the electronic forms or would like to fill out the forms with pen and paper, all of our forms are below. Please select the packet that best fits the reason for your visit.
You can submit the forms in person, via fax (561-898-1710), or email (
Afternoon Light


For patients with head pain, headache, migraine, or similar.

Tropical Leaves

Memory Loss

For patients with cognitive issues. Loved ones fill out pg 18-21.

Plants on the Window


For patients with tremor or Parkinson's.


Other Chronic Pain

For patients with chronic pain besides headaches.

Orange Blossom

Seizures or Spells

For patients with seizures, spells, or blackouts, or similar.


Everybody Else

For patients whom none of the previous categories fit.

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