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Patient Forms

“Listen to the patient. He will tell you what’s wrong with him.” ~Sir William Osler

According to research 35%-56% more information in histories is gathered by using forms. This leads to improved communication, and a quicker diagnosis. Before we can decide if our clinic can provide the care you need, our providers need to review your case.

Please call the front desk to acquire the “New Patient Application.” (We apologize for the paperwork, but this saves us time during your visit; it’s the most efficient way to get the detailed information we need to make a correct assessment and design an effective individualized treatment program for you.)

Upon completing the forms, notify the New Patient Coordinator. From there, our providers will review your case to determine if a symbiotic relationship is feasible; the New Patient Coordinator will call to schedule your first appointment if it is.

At your first appointment, please, come in 15-20 minutes early. Bring your insurance card(s), and any pertinent test results or reports from imaging studies. Please, have your history forms already completed and, please, bring in your medications and any supplements you may be taking.

If you are coming in or considering acupuncture it is highly recommended you fill out and print this questionnaire. Treatment is often based on the patient’s constitutional tendencies, or biopsychotypes, that influence their life and health. To learn more about your biopsychotype, visit Dr. Joe Helms’ “Learning More About You”questionnaire and bring to your acupuncture appointment.

If you are coming in for a pediatric well child check, please print off and fill out the Ages and Stages Questionnaire for the appropriate age.

If you would like us to request a copy of your medical records from another medical office please fill out the medical release and either drop by, mail, fax, or email a signed copy.
Authorization to Release Medical Information

Notice of Privacy Practices
Consent for Treatment
Preferred Method of Communication
Office Financial Policy

Getting the most out of your first visit

Your first visit is very important, as it is during this visit that lays the framework to helping you reestablish your health. The more complete picture we have of your life and health history the better we can serve you.

You can only see the future if you know where you came. The key to restoring health is knowing what set you up for your current issues, what were the triggering events, and what are the mediators that keep you from healing. If we can establish a health timeline we can connect the dots and hopefully unravel the mystery of why you feel the way you do.
Sample Antecedents, Triggers, and Mediators
Blank Timeline
If you can help to fill out a health timeline before your visit, it will significantly help speed up the process of restoring your health.

If you are coming in or considering acupuncture it is highly recommended you fill out and print this questionaire for your initial treatment. Treatment is often based on the patient’s constitutional tendencies, or biopsychotypes, that influence their life and health. To learn more about your biopsychotype, visit Dr. Joe Helms’ “Learning More About You” questionnaire and bring to your acupuncture appointment.

It is recommended you fill out the MSQ at least every 2-3 months to help track your progress, especially if your initial score was greater than 50.
MSQ – Medical Symptom/Toxicity Questionnaire

Please contact the office to be sent the Ages and Stages Questionnaires for well child visits.

You are able to access your lab results/imaging studies on the patient portal as soon as the results become available. You are also able to send secure messages to the office and download your medical records and review your recent visit plans.

Request access to Elation Passport now.

Nasal Sinus Rinse Recipes
Testing Low Stomach Acidity
Hormonal Health and Balance Information
Adjusting Hormone Dosing Questionaire
Hydrogen Peroxide Detox Bath
Colon Transit Time
After Injection Therapy Instructions
Instructions Following Insertion of Hormone Pellet Implants
7 Strategies for Serene Sleep
4 -7- 8 Breath Relaxation Exercise

Integrative Approaches to Anxiety: Easing the Fear
An Integrative Approach to Feeding Your Baby: Starting Solids and Baby-Led Weaning (Baby-Led Solids)
Elimination Diet
The FODMaP Diet
GERD Elimination Diet
Headache Elimination Diet
Headache Diary
Glycemic Index & Glycemic Load
Omega-3 Fatty Acids: Some Frequently Asked Questions
Preparing the Body for Pregnancy and Birth
Probiotics and Prebiotics:Frequently Asked Questions
Improving and Maintaining a Healthy Sleep-Wake Cycle
Therapy for Increased Intestinal Permeability (“4 R” approach originated by the field of naturopathy)
Non-Drug Approaches for Children With Attention Deficit/Hyperactivity Disorder
Non-Drug Approaches to Help Move from Depression to Feeling Happier With More Energy
Gastroesophageal Reflux Disease
An Integrative Approach to Recurring Headaches
Non-Drug Ways to Promote Health by Lowering Blood Pressure
An Integrative Approach for Treating Irritable Bowel Syndrome
Non-Drug Ways to Promote Health by Lowering Cholesterol
Non-Drug Approaches for Managing Osteoarthritis
An Integrative Approach to Healthy Bones: Osteoporosis, Osteopenia, and Fracture Prevention
Integrative Treatment of Hypothyroidism
A Healthy Approach to Weight

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