Please Print, Complete, and Bring the Completed Following Three Forms to Your Next Appointment Or Print, Complete, Scan and Email Completed Forms to MJ@Drpridham.com 

NEW PATIENT HEALTH HISTORY FORM - REQUIRED

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form

NEW PATIENT AUTHORIZATION FORM - REQUIRED

Download & Print Form

INSURANCE POLICY FORM - REQUIRED

Download & Print Form

HIPPA PATIENT FORM (FOR YOUR PERSONAL RECORDS)

Download & Print Form

EQUILIBRIUM WELLNESS CENTER

(505) 872-1900

3901 GEORGIA ST NE BLDG F

ALBUQUERQUE, NM 87110

Monday-Thursday: 9:00am-5:30pm

Friday 9:00am-12:00pm