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New Patient Forms

We offer our paperwork online so you can complete it in the convenience of your own home.


Health History

This lets us know what’s happened, but perhaps more important, where do you want to take your health?

pdf iconClick Here to Complete and Submit Forms

 

Automotive Accident Forms

Please complete the following forms if you have recently been in an automotive accident to help us better understand the severity of your condition and the accident itself.

Auto Accident details

Neck Pain

Back Pain

Insurance Information

 

Massage Professionals Intake Form

If you are new to the Massage Professionals please print the following sheet and have it with you and filled out at the time of your first appointment.

Massage Professionals Intake Form

 Nutrition Patients

Please fill out the following forms as stated in the instructions before your upcoming nutrition exam.   The more detail you can provide the better we can serve you!

Electronic Systems Survey Form – Click on the circles that best describe your symptoms as stated in the instructions.  Please print the filled out copy to bring to your nutrition appointment.

Overview of Symptoms – Please check any symptom you have experienced over the past 6 months.

Toxicity Questionnaire – Fill out this form to determine if you would benefit from a 21 day purification program.

Daily Record of Food Intake – Print this form to keep a 7 day dairy of all the foods you eat.  This will help your doctor analyze what you are eating to make sure your body is receiving the nutrition it needs on a daily basis for optimum function, or to determine if what you are eating is holding you back from reaching your potential.