Adult and Pediatric Intake Forms

Prior to your first visit, you will fill out our comprehensive intake form, which you will bring with you, as well as any lab results or pertinent medical documents.

The intake form can be mailed or downloaded from our website (see buttons below – the pediatric form is for age 10 and under). This form provides the doctors with a thorough medical history and a template for you to outline your health concerns.

Download Adult Intake Form

Download Pediatric Intake Form

Acupuncture Intake Form

Prior to an acupuncture visit, please fill out this intake form and bring it in with you. It can also be emailed to you by request.

Download Acupuncture Intake Form

Colon Hydrotherapy Intake Form

Prior to an colon hydrotherapy visit, please fill out this intake form and bring it in with you. It can also be emailed to you by request.

Download Colon Hydrotherapy Intake Form

Massage Therapy Intake Form

Prior to a massage therapy visit, please fill out this intake form and bring it in with you. It can also be emailed to you by request.

Download Massage Therapy Intake Form