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Contact form

Reach Out to the Team of Dr. Haywood's


Please click on the “Medical Form” link below. Answer all questions as fully as possible and submit your completed form at least the day before your office appointment with us. This will save YOU valuable waiting time.

Don’t forget to bring ALL medical/vision insurance cards and your Driver’s License or Picture ID. If you don’t provide us with the necessary insurance information then you will have to pay out-of-pocket for the services we render to you.