FORMS

New Patient Forms

 

Application for Care

Click here to print the Application for Care form, and fill it out before your first visit.

Use the following link: Application for Care (3 pages) 11-03-20

 

Cancellation and Return Policy

Please note our Cancellation and Return Policy before your first appointment.

 Coming Soon – Please call 320-864-8000 with questions.

 

 

Nutritional Forms

To be used only when directed by your doctor. Please call 320-864-800 with questions.

 

Adrenal Fatigue

Coming Soon – Please call 320-864-8000 to request this form.

 

Daily Record of Food Intake

Use the following link: Daily Record of Food Intake Form (SP)

 

Symptom Survey

Use the following link: Symptom Survey Form

 

Toxicity Questionnaire

Use the following link: Toxicity Questionnaire

 

 

Other Forms

 

Autonomic Nervous System Chart

Use the following link: Autonomic Nervous System Chart

 

Spinal Nerve Function Chart

Use the following link: Spinal Nerve Function Chart