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.

Cancellation and Return Policy (02-11-21)

 

 

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 Form

 

Daily Record of Food Intake

Click here to print the Daily Record of Food Intake form.

Daily Record of Food Intake Form

 

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 Form

 

 

Other Forms

 

Natural Remedies Reference

Click here to print the form.

Natural Remedies Reference Form

 

Autonomic Nervous System Chart

Click here to print the form.

Autonomic Nervous System Chart

 

Spinal Nerve Function Chart

Click here to print the form.

Spinal Nerve Function Chart