Office Forms

Dear Prospective Members,
We desire for your visit to our office to be convenient and time efficient. If you would prefer to complete the following forms prior to arriving at our office, you are welcome to do so. Please remember when completing the “Health History Forms” that the doctor needs as much detail as possible to provide the most appropriate and best care for your situation. We thank you for investing your time into this necessary step of your care. We appreciate your efforts, respect your time and anticipate the opportunity to help you and your family!
Adult Health History Form: All prospective members 13 years old or older should complete this form.
Child Health History Form: All prospective members 12 years old or younger should complete this form.
Nutrition Survey: All prospective members should complete this form prior to beginning our care.
Toxicity Questionnaire: All prospective members 13 years old or older should complete this form.
Terms of Acceptance Form: All prospective members should complete this form prior to beginning our care.
Privacy Notice for MSW: All prospective members should READ this form prior to beginning our care.
Signature Page Privacy Notice for MSW: All prospective members should PRINT and SIGN this form after reading the privacy statement prior to beginning our care.

Contact us

FOR YOUR FREE CONSULTATION TODAY!

Schedule an Appointment Now
We believe that you can be healthy for a lifetime without relying on drugs and surgery. Our soul purpose is to increase your human vitality so you can fulfill your soul purpose!
Copyright ©
Privacy PolicyTerms & Conditions
facebookwpforms