Integrated Health form~ TCM

these are in Jpeg format, so you can download and print, fill in and scan and email to me
or using a photo edit program you add text. if you have any difficulties email me at as well this is where you send the finished forms.

this form has be found online and is very direct and helpful. all information shared is confidential. PLEASE NOTE: in this for where it says REASON FOR VISIT that is where you write the most MAJOR concern or reason for you to seek treatment


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