Naturopathic Initial Visit

INTAKE FORMS (ADULTS)

Please sign and date both forms

Consent To Treat

Adult

INTAKE FORMS (CHILD)

Please sign and date both forms

Consent To Treat

Child

DISCLOSURE AGREEMENT

Please sign and date for Adults and Children

Disclosure Agreement

Each new patient needs the combination of the following completed and signed

Adult OR Child Intake form
Consent to Treat an adult OR Consent to Treat a child

Disclosure Agreement

Mesotherapy

MESOTHERAPY CONSENT FORM

Please sign and date

Consent Form