Forms for your first visit

Please print and bring your forms to your appointment, or email them to me.

* Filling them out online does not auto-send them to me.

You may also arrive 15 minutes early and fill them out in the office. Please let me know ahead of time so I can have them ready.

Hand signing a new patient form with a pen

In-office visits: complete these 4 forms

Form 1

Intake Form

Your health history.

Download PDF →

Form 2

Colorado Mandatory Disclosure

My credentials, fees, and your rights.

Download PDF →

Form 3

Consent Form

Consent to treatment.

Download PDF →

Form 4

Cancellation Policy

Please read and sign.

Download PDF →

Video visits: complete 3 forms

Everyone completes forms 1 and 2. For form 3, choose the one that matches where you will be during your visits.

Form 1

Intake Form

Your health history.

Download PDF →

Form 2

Telemedicine Consent

Consent for video visits.

Download PDF →

Form 3: based on your location

Choose one

In Colorado:
Colorado Mandatory Disclosure →

Outside Colorado:
Out-of-State Disclosure →
Sign page 1. Minnesota clients also sign page 2; Rhode Island clients, page 3.

Before your video visit, please email any lab work and a clear photo of your tongue taken in natural light. I will send you a Google Meet link before the session.

Before your visit

A few tips

Eat beforehand

Please eat something within an hour or two before your appointment.

Come comfortable

Wear comfortable clothing, and please come as fragrance-free as possible.

Bring your labs

For functional medicine visits, please email your lab reports beforehand or bring them with you.

Optional

Environmental toxin assessments

If you suspect environmental toxicity or want to focus on detoxification, please also complete one or both of these.

Optional

Quick Environmental Exposure and Sensitivity Inventory (QEESI)

Download PDF →

Optional

Environmental Toxin Questionnaire

Download PDF →

Questions about the paperwork or anything else? Call (720) 675-7297 or send a message, and we can also go over it before your first treatment. I look forward to meeting you.

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