Patient Forms & Patient/Doctor Messaging

Contact Dr. Frawley or fill out your intake forms by visiting the website Charm Patient Portal or by downloading the Charm App…

Android Lovers: https://play.google.com/store/apps/details?id=com.charm.phr.mphr&hl=en&gl=US

Apple Lovers: https://apps.apple.com/td/app/charm-mphr/id1509064377

Consent To Treat Form

Medical History Questionnaires

The questionnaire is designed to help Dr. Frawley learn your general medical history and to save  time during your initial visit. This will become part of your medical record. All the information you provide will be strictly confidential.  Please fill out the questionnaire online via the email you will be sent when you set up your appointment or bring the completed medical history questionnaire with you to your first scheduled appointment.

Authorization to Disclose Protective Health Information

This authorization must be read, dated and signed by the patient or by a person authorized by law to give authorization on behalf of the patient.