The Natural Health and Healing Center

New Patient Forms

Thank you for scheduling your first appointment with The Natural Health and Healing Center.

Please download and complete the following forms and bring them in with you to your first appointment:

Patient Information Form

Symptom Survey


Be sure to read the instructions carefully on the symptom survey.  Choose mild, moderate, or severe as it applies to you.  If the statement doesn’t apply to you leave it blank.


Additional Forms and Downloads

Daily Food Intake Form