The Healing Alternative
Medical History

Patient Medical History Form
Please download and print the form, complete it legibly, and bring it with you to your first appointment.
Don’t forget to include a list of all current medications,  nutritional and herbal supplements.

Download form here


Note:  This is a  PDF document that requires Adobe Reader to open.

If you are not able to download or print a form, please come to your first appointment twenty minutes early in order to complete a form prior to your appointment.