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Patient education begins with the questions you ask on your intake form. This Health & Wellness Intake Form features patient personal data, past & present health history, a Quality of Life Assessment, and most importantly a checklist of what aspects of their health they'd like to improve. Get to the root cause efficiently with this vitalistic intake form.


· Printable & Editable PDF  

· PracticeHub Code - ready to insert and use! (set up instructional document included)

New Patient Intake Form (English)

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