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Unique Services
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260 Elm Street #105
Somerville, MA 02144
(617) 666-9577
Fax (617) 666-3190
Find Us
Davis Square Family Practice
Office Hours
Monday - Thursday
8am to 6pm
8am - 5pm
Deborah Bershel, MD
Michelle Clark, NP
Carmen Phillips, NP
"Call our office to receive logon credentials."
Barbara Kaplan, LICSW
Andrea Dandridge, NP
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Copyright 2017 Davis Square Family Practice
Patient Forms
   New Patient Questionnaire
   Record Request
For your convenience we provide our patient forms online.  Please feel free to click on any of the below links to view, print and bring with you to your next appointment.

Forms require free Adobe Acrobat Reader to view or print. 
Click here to get Acrobat Reader.
Click here to download your free version of Adobe Reader
   Child Registration Form
   Adult Registration Form
   Waiver and Release