Forms

If you're a first-time client, please review and complete the following forms. Please scan back by email or fax 24 hours prior to your scheduled intake. Fax 888.910.0622.

Other forms:

  • Consent to Release Information Form (if required) Use this form is you wish to authorize a release of information or coordinate information with another medical or legal entity, such as a medical doctor, medical laboratory, psychiatrist, endocrinologist, or attorney. This release is specific to persons, agencies, medical entities, and to obtain test results (of any kind) and attorneys. Please fill one out for each entity you wish to release information to or from.

SYMPTOMS

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Helpful Forms

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