FORMS

New Patient Forms

 

Application for Care

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

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

Click here to print the Adrenal Fatigue form.

Adrenal Fatigue (12-10-18)

 

Daily Record of Food Intake*

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

 

Symptom Survey

Click here to print the Symptom Survey form.

Symptom Survey Form

 

Toxicity Questionnaire

Click here to print the Toxicity Questionnaire form.

Toxicity Questionnaire (03-18)

 

 

Other Forms

 

Natural Remedies Reference

Click here to print the Natural Remedies Reference form.

Natural Remedies (01-27-21)

 

Autonomic Nervous System Chart*

Use the following link: Autonomic Nervous System Chart

 

Spinal Nerve Function Chart*

Use the following link: Spinal Nerve Function Chart