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New-Patient Forms

CONTACT US

Phone:
(818) 986-0911

Fax – (818) 986-9301
Email – info@drbenzur.com

QUICK LINKS

New patient documents

Location/Directions

If you wish, below is a link to download our new patient forms

New Patient Health Screening/History Forms

Please complete them, and fax it to us at 818-986-9301.