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Forms

Prior to your first appointment, please download and complete the following forms. (You may also fill out these forms when you arrive at our office, but having them prepared ahead of time will help expediate your appointment).

Registration form
PDF | MS Word .doc

Current Medication List
PDF | MS Word .doc

Medical Records Request
PDF

Lyme Disease Symptom Checklist
PDF | MS Word .doc

Informed Consent for Treatment of Persistent Lyme Disease
PDF | MS Word .doc

Restriction of Use Policy
PDF | MS Word .doc

Office Policies
PDF

 

Location and hours

Lyme Center of New England
573 Mendon Rd. (Route 122) Suite 3
Cumberland, RI 02864


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Office Hours: by appointment only. Evenings and weekends available. Please call 401-334-LYME (5963) to schedule your appointment.

Contact us

Service Times & Directions

Weekend Masses in English

Saturday Morning: 8:00 am

Saturday Vigil: 4:30 pm

Sunday: 7:30 am, 9:00 am, 10:45 am,
12:30 pm, 5:30 pm

Weekend Masses In EspaƱol

Saturday Vigil: 6:15pm

Sunday: 9:00am, 7:15pm

Weekday Morning Masses

Monday, Tuesday, Thursday & Friday: 8:30 am

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6654 Main Street
Cincinnati, OH 45202
(513) 555-7856