Intake Forms.
For the first appointment, please download the 3 Part Adult Medical Intake forms, the nutritional questionnaire and the New Patient Intake forms. Do add up the scores in the nutritional questionnaire. Either Fax or mail the completed paperwork to 3180 Adams Road,Sacramento, CA 95864, at least one week before your appointment.
Please add up the totals in the Nutritional questionnaire. Thanks.
| adult_medical_intake_part_1.pdf |
| adult_medical_intake_part_2.pdf |
| adult_medical_intake_part_3.pdf |
| billing.pdf |
Questionnaires
| environmental_exposure_history_form.pdf |
| environmental_sensitivity_questionnaire.pdf |
| toxin_exposure_questionnaire_adult.pdf |
| nutritionalquestionnaire_2.pdf |
| medical_symtoms_questionnaire.pdf |
New Patient Forms
| new_patient_intake_forms.pdf |
Childrens Weekly Symptom Checklist
| childrens_symptom_checklist.pdf |