2000 Foulk Road Suite A
Wilmington, DE 19810

Patient Registration Forms



Please print the Patient Information, Patient Medical History (2 pages), Patient Privacy Consent, and the IQHealth Patient Portal forms and FAX or MAIL the completed forms to Dr. Berg's office as soon as possible. 

Patient Information Form (print this form)

Patient Medical History Form (print this form)

Patient Privacy Consent Form (print this form)

IQHealth Patient Portal (print this form)

Notice of Privacy Practices (Please read before your appointment; do not send to Dr. Berg's office)


2000 Foulk Road Suite A
Wilmington, DE 19810

Call: 302.475.8000

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