Intake Forms for Male Patients Seeking Naturopathic Medical Care
Intake Forms for Female Patients Seeking Naturopathic Medical Care
Intake Forms for Patients Seeking Only Psychotherapy
Background Information Forms for Out-of-State Health Education Consultations
Follow-up Visit Assessment Forms
Forms for patients seeing Dr. Clifford:
Adult Intake Form. This is for all new adult patients.
Child Intake Form. This is for all new child patients.
HIPAA Privacy Notice. This is for all new patients or their guardians to read. It need not be returned to Dr. Clifford
Note: To download Adobe Acrobat Reader for free, click here.
Start your new path in life and be the change today!
Click here to view and print forms for your appointment.