New Patient Health History Form
The Center for Health and Healing offers our patient form(s) online so they can be completed it in the convenience of your own home or office. Thank you for your time. We greatly look forward to meeting you at your first appointment.
New Patient SYMPTOM SURVEY Form Download & Print Form – Required
New Female Patient NRT Form Download & Print Form– Required
New Male Patient NRT Form Download & Print Form– Required
New youth NRT Form Downloads & Print Forms-Required
- If you do not already have AdobeReader® installed on your computer, Click Here to download.
- Download the necessary form(s), print it out and fill in the required information.
- Fax us your printed and completed form(s) or bring it with you to your appointment.
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