The doctor of the
future will give
no medicine, but interest his patients
in the care of the
human body,
in diet, and
in the cause and prevention of
disease."

~ Thomas Edison ~
           

Below are four (4) documents for New Patients to fill out and bring to your first office visit. 

Note:  Please ensure you complete all four (4) forms.


(1) Patient Info, (2) Office Policies, (3) Privacy Acknowledge*

    ·  There are 3 separate documents in this PDF file.  Print them out and fill in information.
           * click here to read and/or print a copy of the Notice of Privacy Practices
 

·  PLEASE NOTE:  In addition to the above 3 documents, you also need to fill out the appropriate
                              Health History Form below and bring with you to first office visit.

(4) Health History Form - please select appropriate form below

Patient Health History Form - (For patients 18 and older)
 

Pediatric Health History Form - (For patients under 18 only) - print and fill out form

The forms require Adobe Reader or other PDF reader.  If you need to install Adobe Reader,
it is available to download and install free of charge at the following link.

 

© 2010 McNeill Naturopathic Clinic, LLC - All rights reserved