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Darien Integrative Medicine
6 Thorndal Circle – Suite 102
Darien, CT 06820
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Patient Forms

Michael E. Doyle, MD

Patient Forms

Patient Forms

Patient Forms

Darien Integrative Medicine
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Instructions for New Patients

Thank you for trusting Darien Integrative Medicine. 

Completion of the CONSENT, MEDICARE CONSENT (if age 65 or older) & NEW PATIENT FORMS are required BEFORE scheduling an appointment. 

Please complete the required forms using a desktop or laptop computer.  

*Do not use an iPhone, iPad or smartphone. 

Allow-up to 45 minutes to complete 

Answer all questions; type “ NA ” (not applicable) for questions that do not apply. 

Do not hesitate to call us if you encounter technical difficulties. We are here to help. 

To make the most of your appointment, please: 

Plan to arrive 15 minutes early for check-in; please consider traffic. 

Do not bring medical records. We will ask you for what we need.    Exception: bring the report from any recent thyroid ultrasound or thyroid biopsy. Do not bring the original. 

Dress comfortably – you will be asked to change into medical scrubs before your physical examination. 

Write down your questions, we will try to answer as many as your appointment time will allow. 

Schedule extra time for additional discussions or record reviews or long-distance appointments. 

Understand that we will NOT order tests before your first appointment. 

Thank you. 

Call us immediately after completion to schedule your appointment.

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