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

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

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

childrens_symptom_checklist.pdf | |
File Size: | 132 kb |
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