Intake Forms
Please fill out as thoroughly as possible and either email (Dr. Chris Ford - [email protected] or Dr. Darcie Pawlick - [email protected]) or fax (778-481-5009) them back to us or print it out and bring them to your initial visit.
Note: Please save the form to your computer desktop BEFORE filling it out in order to save it after it has been completed. If you have any questions please contact us.
Adult Intake Form
Roots to Health Intake Form - Adult | |
File Size: | 183 kb |
File Type: |
Child Intake Form - 12 and under
Roots to Health Intake Form - Child | |
File Size: | 217 kb |
File Type: |
Adult and Child Consent Form
Roots to Health Consent Form | |
File Size: | 132 kb |
File Type: |
Acupuncture Intake Form
Roots to Health Intake Form - Acupuncture | |
File Size: | 76 kb |
File Type: |
Acupuncture Consent Form
Roots to Health Consent Form - Acupuncture | |
File Size: | 132 kb |
File Type: |
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