Forms and Checklists

Please download and bring in the intake form below:

*For acupuncture – Adult Short Intake
*For longer consultations – Adult Long Intake
*For Classical Homeopathy – 1. Adult Long Intake and 2. Homeopathy Intake
*For kids to age 17 – Pediatric forms

Signs of Exhausted Adrenals

five_elements_checklist

yin_yang_checklist

Candida Checklist

Adult Short Intake Form

Adult Long Intake Form

Pediatric Intake Form

Special Homeopathic Intake Form

New Sankaran’s Intake Form

Dr. Amen’s ADD/ADHD/OCD Intake for Child or Teens

Metabolic Assessment Form

Diet Chart

Neurology Questionnaire

Diets:

• Sugar Control Diet
• Low Stress Diet

Basal Testing:

• Basal Thyroid Temperature
• Low Thyroid Checklist
• Barnes Thyroid Test
• Underarm Temperature Test

Jung Typology Testing