Natural Medicine Clinic FormsNatural Medicine Clinic Forms

We ask that you please print out and thoroughly complete and sign all of the forms prior to your first appointment with us.  It is preferred that you either fax, mail or email these completed forms a few days ahead of your first visit in order to give us the opportunity to review the information contained therein.  This will allow us to have a more productive office visit with you.   Our mailing address is:  P.O. Box 825, Fairforest, SC  29336.  Our email is:, and our fax is: (925)380-4944.  Thank you!
Please click on the links below in order to access the forms:

Natural Medicine Clinic Health History Questionnaire

Natural Medicine Clinic Patient Diagnostic Questionnaire

Natural Medicine Clinic Informed Consent