Downloadable Forms

Forms you can download, print, and fill out before you arrive

Below is a list of patient forms and informational documents, which may be downloaded and printed from your computer. To download:

  1. Right-click (PC users) or Ctrl-click (Mac users) the link to the document.
  2. Select Save Target As or Save Link As and save the file to the desired location on your computer.

For PDF files, you must have Adobe Acrobat Reader installed on your computer. Download the free Acrobat Reader software here.

  • Fertility History (70.77 kb)
    Print this form if you are seeking fertility treatments.
  • Adult Intake Form (136.09 kb)
    Fill out this form if you are 14 years or older.

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  • Spring Cleanse 2016 (0 bytes)
  • Pediatric Intake Form (126.9 kb)
    Form for child 13 years of age or younger.
  • HIPAA Privacy Policy (95.74 kb)
    Read this form for information on our office privacy policies.
  • Records Release (52.67 kb)
    Print and fax this form if you need your medical records sent to another healthcare professional.
  • Detox Group Application (83.83 kb)
    Print this form if you are interested in joining one of the upcoming detox workshops. Bring it with you to the first class.