New Patient Paperwork

STEP 1: Select one of the following questionnaires…

Your Information. Your Rights. Our Responsibilities. 
Read Our HIPPA Notice

 

STEP 2: Fill out the questionnaire…

All of the forms can be completed electronically on your computer. Simply download the PDF to your computer, open in your PDF program and save any changes you make when you’re done. You can also print the PDF and fill it out with a pen.

 

STEP 3: Email us the PDF…

Send an email to info@wellnessrevolution.com and attach the completed PDF. If you printed out the PDF, you can bring it with you to your first visit.