Intake Forms

Intake forms are available in two formats:

  • Download the DOC forms if you would like to edit them on your computer.
  • Use the PDF forms to print from your computer to fill out by hand.

For editing DOC files, we recommend free open source programs: OpenOffice for Windows and NeoOffice for Macintosh.  Viewing PDF files may require Adobe Acrobat Reader.

  • New clients: Initial Clinical Intake DOC PDF
  • New and returning clients: Client Intake DOC PDF
  • Nutrition & lifestyle consultations: Nutrition Health History DOC PDF
  • Grass Roots Health Care
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