Our ability to draw effective conclusions about your present state of health and how to improve it depends, to a significant extent, on your ability to respond thoughtfully and accurately to both these written questions and those posed by the clinician during your consultations. Health issues are usually influenced by many factors. Accurately assessing all the factors and comprehensively managing them is the best way to deal with these health challenges. Your careful consideration to the questions contained in the forms below will enhance our efficiency and will provide for more effective use of your scheduled consultation time. These questions will help to identify underlying causes of illness and will help us formulate a treatment plan. Please take the time to print them at home and bring them with you to the office.
Adult Intake Forms
- Acupuncture Consent
- Adult Consent
- Medicare Contract
- Adult Intake
- Functional Medicine Info
- Supplement-Consent
- Privacy Form
- Medical Follow Up [Online]
- Office Policies
- Medical Marijuana Consent Form
Pediatric Intake Forms
- Child Consent
- Child Intake
- ASD Child Intake
- Functional Medicine Info
- Medical Symptoms Questionnaire
- Privacy-Form
- Office Policies
Questions? Please Call Us
Office Telephone Number (717) 243-0616