nat-intake-02

Naturopathic New Patient Intake – Adult

This questionnaire provides a thorough overview of an adult patient’s condition upon their intake at a naturopathic clinic. Included in this comprehensive five-step form is a patient’s basic contact information, other healthcare providers, and how they heard about the naturopathic clinic. It moves on to dozens of questions about the patient’s current health concerns sorted by bodily systems, as well as any reproductive concerns, and their medical history. The final step of the form asks patients for their authorization and signature.

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