Potomac Rejuvenation Center

Call: (202) 836-6232

For more information


Medical Forms

When you call us to discuss your needs and learn more about our program, we’ll ask you to complete a medical intake form, which helps us learn more about you, your specific needs and concerns, and your medical history. Our medical team will study this and review it carefully with you during your first appointment to help create a tailored program specific to you.

But, if you wish to save time, you may complete this form any time and bring it with you for your first appointment.

>> Download Medical Intake Form