Natural Care of Westchester

Welcome!
Thank you for the opportunity to work together towards your optimal health. To help prepare for our first visit together and insure an efficient visit, please follow these steps:

Please click on, download, and fill-out these forms:​

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• Intake Form
• Symptom Survey
• Daily Food Diary   (multiple of these)
• Appointment Guidelines
• Metabolic Form (please only fill this out if there are weight or digestive issues)

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For women over the age of 18:

Female Health History form

Female mood questionnaire

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For men over the age of 18:

Male Health History form

Male mood questionnaire

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Make copies of the one page Diet Diary and fill it out for as many days as you can (up to four days and two weekend days would be ideal). Please do not change your eating habits or life style during this time so we can get an accurate assessment of your nutrient intake and current symptoms.
 

If you can, bring in (or list)  all supplements and medications you are taking to your first visit so we can review them together. Do not ever change or alter dosages of any prescription medications with out speaking with your prescribing physician.​

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To reduce paper:

If you have an Apple computer: fill out forms on preview and send it to

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If you have a pc/android: follow the link and you will get the instructions for the appropriate application to fill and sign the PDFs.

 

https://www.easytechguides.com/electronically-fill-and-sign-pdf-forms-and-documents.html
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Feel free to email us any time if you have any questions.