top of page

Established Patient
Intake Forms

Are you a current patient or have visited the clinic in the past? Please fill out this paperwork to keep us up to date. If you have not received a treatment from us in more than 5 years, please re-complete the "new patient paperwork."

All patient visits are documented on intake forms that allow you to describe current health issues, order herbal and health products, and serve as your receipt/superbill for reimbursement.

We would prefer that you fill out the online forms, but if you want, you can download a PDF to manually complete. Please print the dowloaded PDF as a 2 sided document if possible.This will fit our filing system better.​ Thank you and look forward to seeing you!

bottom of page