Forms
Prior to your first appointment, please download and complete the following forms. (You may also fill out these forms when you arrive at our office, but having them prepared ahead of time will help expediate your appointment).
Registration form
PDF | MS Word .doc
Current Medication List
PDF | MS Word .doc
Medical Records Request
PDF
Lyme Disease Symptom Checklist
PDF | MS Word .doc
Informed Consent for Treatment of Persistent Lyme Disease
PDF | MS Word .doc
Restriction of Use Policy
PDF | MS Word .doc
Office Policies
PDF
Location and hours
Lyme Center of New England
573 Mendon Rd. (Route 122) Suite 3
Cumberland, RI 02864
Office Hours: by appointment only. Some weekends available. Please call 401-334-LYME (5963) to schedule your appointment.