Intake forms are required by all new patients. Please download the forms, fill them out completely, and return before your appointment. Patients must send:
- Patient Questionnaire (please let us know if you are unsure which form is appropriate)
- Last Bloodwork/lab results
- Signed Privacy Policy
Please note: Dr. Henderson cannot consult with patients without first receiving your completed forms.
NEW PATIENT FORMS
Click here to download:
New Patient Questionnaire
Last Bloodwork
Privacy Policy
Instructions: Please download the forms and save to your desktop. If you do not have Acrobat Reader, you can install the latest version by clicking here:
Adobe Reader for Windows
Adobe Reader for Mac
Forms can be filled out, saved, and emailed to appointments@holistickidney.com, or you can send via postal service.
Payment is due in full at the time of service. Payments can be made online, or included with your mailed forms.
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