New Patients | Healthfit

Clinical Forms

New Patient Administrative

A.
Confidential Health Information Questionnaire

E.
Consent to Email,
Text & Voicemail

B.
General
Medical History

F.
Financial Policy

C.
Integrative Health Policy & Consent to Care Agreement

D.
Hippa Privacy Policy, Treatment Consent, Claims Processing Consent

Functional Medicine

1.
Functional
Medicine Intake

2.
Neurotransmitter Assessment Form (NTAF)

3.
Metabolic
Assessment

4.
Understanding
Our Goals

Chiropractic

1.
Patient Health Questionnaire – PHQ

5.
Functional Rating Upper Extremity

2.
Patient Follow-up Questionnaire

3.
Functional Rating Neck and Back Index

4.
Functional Rating Lower Extremity

Acupuncture

1.
New Patient Intake

Massage

2.
New Patient Intake

1.
Terms & Waiver

Misc.

1.

Release of

Medical Records