Optimum Wellness Naturopathic Medical Clinic
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Intake Forms & Instructions


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Patient Intake Forms

Please print off and fill out the form that pertains to you and bring it with you to your initial appointment. This saves both yourself and our staff time and we really appreciate it!

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Adult Intake Form (for patients 8 years old and up)

Child Intake Form (for patients 7 years old and under)

Heavy Metal / Chelation Intake Form




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