Forms

Our initial paperwork is now online!

When you schedule your visit you will be sent a text and email which contain 2 links. One link will take you to our medical consent forms and the other link will allow you to fill out the general intake. If you do not do this before your initial visit or prefer filling out actual paperwork you can print our hardcopy forms below. 


If you have not filled out our digital paperwork you may print and fill out the indicated forms before your visit. You can also securely fax your filled out forms to 888-630-1986.

Adults (and young adults 12 and up)

Adult New Patient Intake  РRequired

New Patient Consent To Treatment – Required

Pure Health Homeopathic Intake– Optional but helpful (you may be asked to fill this out at a later time)

Pure Health Membership Agreement – Optional

Children (Under 12)

Pediatric Intake (Age 12 and under)

Pure Health Homeopathic Intake– Optional but helpful (you may be asked to fill this out with your child at a later time)