This form is a confidential health assessment tool which will give insight into your personal health status. When designing an individualized health plan it is important to begin with a thorough understanding of where you are currently, your personal and family health history, as well as your habits, thoughts and concerns regarding your health. Please take the time to answer the questions on the form as honestly and accurately as possible.
It will take approximately 15 minutes to complete – and you will require detailed information about your health history, including your current medications and supplements – so it is recommended that you fill out the form at home, prior to your initial visit.
The majority of your initial visit will involve reviewing this form, so please be sure to bring it with you to your first appointment.
Thanks in advance!