FORMS

Energy Medicine Bay Evaluation Form – Please fill out if have scheduled a 30 minute Bay Evaluation

Comprehensive Patient Intake Form – Please fill out if you have scheduled a 1hr Private Session

Child Assessment Form – fill out for children under 12 IN PLACE OF the metabolic and neurotransmitter questionnaires at the end of both of the above forms

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ATTENTION:

Please send the above forms along with any recent labwork and/or x-ray/MRI/CAT scan reports – to the HEAL Center at least 2 days before your scheduled appointment- either email them to: frontdesk@healatheal.com or fax to : 303-440-4346       If we do not receive all forms in full prior to your appointment- then we will need to reschedule you to a later date.

** also please bring with you to your appointment any nutritional supplements or prescription meds you are taking