Intake Forms

Roots and Branches New Patient Intake Forms

Prior to your first visit, there are a couple intake forms for you to fill out. You can download these by clicking the button below. If you are unable to download the forms, please contact our office and we will be happy to email or mail a copy to you.

The forms include a number of questions addressing diet, lifestyle, past medical history, and family medical history. They also include consent and release forms. Please take time to fill these out completely. All the answers are important in understanding you as a whole person and will greatly aid in the evaluation of your health conditions. If you are planning to fill these out at the time of your first visit, please allow yourself 20 to 40 minutes depending on the extent and complexity of your medical history. If you can, please include a complete list of any prescription medications, over the counter drugs and/or vitamins and supplements that you are currently taking, as well as any medical lab results that you have had done in the past year.

New Patient Forms