INTAKE FORMS

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DIRECTIONS For pdf files: Click on file to open, print, and fill in by hand.

Bring the Intake Form to the first visit.

Also fill out and bring any other relevant questionnaires.

Also bring your lab tests for the last 1 - 2 years.

•  Patient Intake Form   (pdf)

•  Chronic Fatigue Questionnaire   (pdf)

•  Food Allergy Questionnaire   (pdf)

•  Autism Treatment Evaluation Checklist  (pdf)

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