Forms

Please print and fill out these forms completely and bring with you on your first visit:

Case History

Patient Discomfort

IMPAC Privacy Practices

This clarifies our financial agreement with you and is needed at your first visit.

Financial Policy

If you are interested in a Nutritional evaluation, please print out this two page form, fill it in and bring to your first visit.

Metabolic Assessment Form

If you are bringing a child under the age of 18, please print and complete this form:

Consent to Treatment of a Minor