Please fill out the following forms. Please note that we need time to analyze the results and prepare for your session so in the event that we receive these after your paperwork due date we cannot guarantee that the results will be ready. If you have any questions please call 925-280-4442 or email email@example.com.
Note that you may or may not be asked to fill out all of these forms. Please review the email we sent with the forms you need to fill out.
Intake Form: Click here for the Intake Form – This will take you to a new page and you will fill out the information. An email will be sent to you and you will need to click a link to finalize the process.
Food Journal: You will need to do a food journals for three days. Click here for the food journals.
HAQ: Fill out your Health Assessment Questionnaire Click here for the HAQ.
HIPAA Confirm your HIPAA form Click here to approve the HIPAA.
Insurance Client Form Click here to fill out the form for insurance clients.
Health History: Fill out your Health History Click here.
Note that if you do NOT have MRT Testing (Food Intolerance Testing) as a part of your package then you do not need to fill out the forms below. If you do then we need these forms filled out as well.
MRT (if you have MRT Testing): Click here for your MRT Initial Symptoms Assessment.