Our Wellness Center offers a few patient forms online so you can complete them in the convenience of your own home or office.
- If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download it for free.
- Click on the necessary form below, print it out and fill in the required information.
- Fax your printed and completed forms to us at (623) 878-0640 or bring them with you to your appointment and save time on your visit!
Free AdobeReader®
REQUIRED HEALTH FORMS
This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!
- Required for All New Patients: Health History Form
- Required for New Medicare Patients: aBN-medicare-Form. PDF
QUESTIONNAIRES Required for new nutrition patients:
Healthy Living Questionnaire
Toxicity Questionnaire