Please complete our New Patient forms and submit prior to your first visit. These forms must be filled out completely for ALL ADULT PATIENTS:

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• ​New Patient Form

• ​Patient Questionnaire

 

 

These forms must be filled out for all adult patients who suffer from Diabetes, Thyroid Disorders, Neuropathy, Migraine Headaches, Depression, Anxiety, ADHD, ADD, Fibromyalgia, Vertigo, and Chronic Pain Disorders:

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• ​Neurotransmitter Assessment

• ​Metabolic Assessment

• Brain Health and Nutrition Assessment

 

 

Autism/ADHD/ADD & Dyslexia  Intake Forms:  These forms must be filled out completely prior to child's initial visit:

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• ​Child Health History

• ​Master Hemispheric Checklist

• ​Child Neurotransmitter & Nutrition Questionnaire

• ​Patient Questionnaire

• ​Behavioral Evaluation Record

 

Please make sure to have all necessary forms filled out completely.  Also be sure to sign forms. 

These forms are extremely important to give us an understanding of your health history, and they play an integral role in beginning the process of qualifying you for care.  Thank you, and feel free to call the office with any questions.