• Call Us Today! (860) 535-4600
  • Email: care@yourcountrydoctor.com - *Please do not send medical information by email, call for appointments and Rx refills

Call Us Today! (860) 535-4600

Email! healing@yourcountrydoctor.com

Patient Forms

Dr. Pecher Adult Health
Assessment Form

Dr. Pecher Auth To
Disclose PHI

Dr. Pecher HIPAA
Acknowledgement

Dr. Pecher HIPAA
Form

Dr. Pecher Medication
List

Dr. Pecher Patient
Registration Form

Dr. Pecher Release
of Information

Dr. Pecher Text/Email Consent