Forms

Find the forms that you’ll need for your Initial Consultation

Informed Consent – for all new patients

Adult Intake – for all new patients 16 years of age or more (younger teens may also use this form if they feel that it’s more appropriate)

Pediatric Intake – for all new patients 15 years of age or less

Use this form for Childhood Wellness Consults

Childhood Wellness Intake – please do one form each per child

Use these forms for our Annual Cold & Flu Clinic (these must be re-done each year)

Flu Clinic Consent – Individual – use this form if you are attending/picking up just for yourself

Flu Clinic Consent – Family – use this form if you are a couple or family. Fill in the first family member’s name at the top, and the other family members at the bottom