Holistic Therapies: Patient Forms

Patient Forms

You can find forms that will allow you to get started in our office as quickly as possible here.

To begin, we generally need to have (2) items completed. The New Patient Intake and the Nutritional Questionnaire - Items 2 & 3. Once completed, please return to the office via mail, email, fax - we ask 3 days prior to your appointment in order to help direct and focus your initial visit. Please also find/review office guidelines, terms and conditions and HIPAA notice. Note: all forms are in PDF format. If you have other requirements please contact the office - we would be happy to mail you hard copies.

Holistic Therapies Brochure

For your first visit start with these :

New Patient Intake
Nutritional Questionnaire initially, as a follow up - generally every 6 visits to access progress.

You may find these helpful in time:

Diet Diary
Basal Body Temperature
Digestive Dose


These are the forms you sign to start a chart in our office: - We must witness.

Office Guidelines
Terms and Conditions of Service
Notice of Privacy Practices (HIPAA)


Release of Records Policy
Record Release Form


Please note our Electronic Communications policy