214 Russell Street, Starkville, Mississippi • (662) 323-2371
Forms for New Patients

Medical History Form (PDF)
Once you have made your appointment, you may print and complete the linked file to speed up your first visit. Either bring the completed form with you to the office, or FAX the form in advance to 662-323-2382.

Consent to Treatment
You may want to read the informed consent form before your visit, and ask Dr. Leach if you have any questions. In addition, after your examination he will discuss your case with you further, and ask for your permission before giving you any treatment.