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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
File Size: 374 kb
File Type: pdf
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adult_medical_intake_part_2.pdf
File Size: 203 kb
File Type: pdf
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adult_medical_intake_part_3.pdf
File Size: 136 kb
File Type: pdf
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billing.pdf
File Size: 303 kb
File Type: pdf
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Questionnaires 

environmental_exposure_history_form.pdf
File Size: 144 kb
File Type: pdf
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environmental_sensitivity_questionnaire.pdf
File Size: 69 kb
File Type: pdf
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toxin_exposure_questionnaire_adult.pdf
File Size: 68 kb
File Type: pdf
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nutritionalquestionnaire_2.pdf
File Size: 50 kb
File Type: pdf
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medical_symtoms_questionnaire.pdf
File Size: 1218 kb
File Type: pdf
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New Patient Forms

new_patient_intake_forms.pdf
File Size: 1299 kb
File Type: pdf
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Childrens Weekly Symptom Checklist

childrens_symptom_checklist.pdf
File Size: 132 kb
File Type: pdf
Download File

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