Online Paperwork
Please fill out these necessary forms and bring them with you to your first visit.
New Patient Chiropractic Forms
**Please fill out all forms in this section**
Optional
Functional Nutrition History
Diet, Nutrition, and Lifestyle Journal – 1 day
Diet, Nutrition, and Lifestyle Journal –3 day
Diet, Nutrition, and Lifestyle Journal – 7 day
Medical Symptoms Questionnaire
IFM Meal Plans
Detoxification
Cadiometabolic 1200 – 1400 calories
Cadiometabolic 1400- 1800 calories
Physiology and Function Resources
Decrease Allergen Exposure at Home
EMF Exposure – Sources and How to Avoid Them
Inflammatory Lifestyle Contributors
List Testing for Low Stomach Acidity
Nutrition Influences on Estrogen Metabolism
Reducing Toxicity and Chemical Exposures
Resources – Detoxification Websites and Reading List
Resources – GI Websites and Reading
Resources – Women’s Health Reading
Physiology and Functions Questionnaire
Candida Screening Questionnaire CFIDS
Environmental Exposure History Form
Environmental Sensitivity Questionnaire
Fibromyalgia Impact Questionnaire Part 1
Fibromyalgia Impact Questionnaire Part 2
Short Inflammatory Bowel Disease (IBD) Questionnaire
New Patient Functional Nutrition Forms
Medical Symptoms Questionnaire
Lifestyle Interventions
Lifestyle Questionnaires
Daily Activity Questionnaire
Depression Anxiety Stress Scales (Questionnaire)
Nutrition Interventions
Cardiometabolic Food Plan – Comprehensive Guide
Cardiometabolic Food Plan – Food List
Food Plan – Food List 1200-1400 Calories
Cardiometabolic Food Plan – Food List 1400-1800 Calories
Cardiometabolic Food Plan – Food List 1800-2200 Calories
Food Plan – Weekly Planner and Recipes
Core Food Plan – Food List 1200-1400 Calories
Core Food Plan – Food List 1400-1800 Calories
Core Food Plan – Food List 1800-2200 Calories
Detox Food Plan –Comprehensive Guide
Detox Food Plan – Weekly Planner and Recipes
Elimination Diet – Comprehensive Guide
Elimination Diet – Phytonutrient Spectrum Foods
Elimination Diet – Weekly Planner and Recipes
Food Reintroduction Symptoms Tracker Food
Food Sources of Cruciferous Veggies
Food Sources of Essential Fatty Acids
Functional Nutrition Eating Your Way to Better Health
GI Specific Diet – FODMAP Intolerances
Mito Food Plan – Comprehensive Guide
Mito Food Plan – Weekly Planner and Recipes
Nutrient Rich Foods
Phytonutrient Spectrum – Checklist for Kids
Phytonutrient Spectrum – Comprehensive Guide
Phytonutrient Spectrum – Day of Rainbow Recipes
Phytonutrient Spectrum – Foods
Food Plan_v 6
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