Tranquil Healing Center
Tranquil Healing Center
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    • Home
    • About Us
    • Naturopathic Medicine
    • Midwifery
    • Client Forms
    • Supplement Orders
    • Contact

  • Home
  • About Us
  • Naturopathic Medicine
  • Midwifery
  • Client Forms
  • Supplement Orders
  • Contact

Client Forms

Naturopathic and Midwifery Forms

Please fill out the forms that pertain to you. 

  • Adult Intake Form: Any new patient over the age of 13yo or current patients that have not been in for a visit in the last 3 years
  • Child Intake Form: Any new patient under the age of 13yo or current patients that have not been in for a visit in the last 3 years
  • HIPAA Compliance Form: All New patients or current patients that have not yet been to the clinic.
  • Visit Update Form: If you would like to pre-fillout this information please do. We will ask you to fill one out at the clinic prior to your return appointments.
  • Records Release Form: If you have labs, notes, or other information from a current or previous practitioner that may be helpful please fill this out.  

HIPAA_Practices_Form (pdf)

Download

Visit Update Form - filled out for every visit (pdf)

Download

Child Intake updated (pdf)

Download

Adult Intake Form (pdf)

Download

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