PDF
Weight Loss Program Intake
PDF · 545 KB
New-patient intake packet for our medically supervised weight loss program. Includes health history, medication list, and program agreement. Complete and bring to your first appointment.
Patient Resources
Download and complete your intake forms before your visit so we can spend more time on you and less on paperwork.
Download
Save the PDF to your computer or phone.
Print & Complete
Print the form and fill it out in pen at home.
Bring to Visit
Bring the completed packet to your first appointment.
Weight Loss Program Forms
Required intake paperwork for our medically supervised weight loss program.
Regenerative Medicine Forms
Medical history and intake paperwork for stem cell and regenerative therapies.
- PDF
Stem Cell — Medical History & Intake
PDF · 552 KB
Comprehensive medical history and intake form for stem cell therapy candidates. Complete this packet before your initial regenerative medicine consultation so our team can review your history in advance.
Preparing for Your Visit
- Complete your intake forms ahead of time and bring them to your first appointment.
- Bring a valid photo ID and your insurance card (if applicable).
- Review any pre-treatment instructions specific to your scheduled service.
- Arrive 10–15 minutes early for paperwork and check-in.
Privacy & HIPAA
All forms are downloaded directly to your device. We do not collect or store anything you type into the PDF until you hand the completed packet to our team in person.
Need Assistance?
Our team is here to help with forms, appointments, or any questions about your care.