New Patient Required Forms:
√ New Patient Intake Form -
Required
√ Consent To Treat Authorization -
Required
√ Liability Release - Required
√ Notice of Privacy Practices (HIPPA) - Required
(The Notice of Privacy Practices is yours to keep. We only need a copy of the first page for our records, indicating you have been provided a copy of the document.)
2 - Nutrition Patient Forms:
√ Authorization Release
√ Male
√ Female
√ Youth
√ Youth Authorization Disclaimer
√ Toxicity Questionnaire
√ Nutritional Procedure-Start To Finish
√ Daily Record of Food Intake
(This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!)
Additional New Patient Forms:
These forms can be downloaded and printed prior to your first office visit: