Patient Intake Forms

Please download and print the patient forms then fill them out prior to arriving for your first visit. This will help insure the best use of your time.

If you want to fill out the forms in the office, please arrive 30 minutes before your appointment.

Adult intake form – Please fill out this form for adults 12 years old and older.

Birth-to-5yo-Health-History-long-5-3-08-2 – Parents, fill this form out for your infant or child up to 5 years old.

6-to-12-year-old-Health-History-8-25-08 – Parents, fill this form out for your child 6 to 12 years old.

massage-and-cranial-health-history-form-9-09 – Intake form for shiatsu massage or cranial therapy
(not in association with a Naturopathic medical visit).

If you have questions about which form you need, please contact the office at 503-227-8700.