Client Forms

Client Forms

Informational Forms

As a medical services provider, client data is extremely important to our operation. The following forms give us the medical, personal, and analytical information we need to provide you with the best services possible. We thank you for taking the time to fill them out.

New Client Information

Help us learn a little more about you. With comprehensive data on your medical history, allergies, and health specifics, we’re better equipped to help you.

Counseling Agreement

This release gives Total Health Concepts express permission to carry out counseling services to the best of its qualifications and abilities.

HIPPA

The Health Insurance Portability and Accountability Act (HIPPA) provides data privacy and security provisions in the medical environment. This helps us keep your data private.

Informed Consent And Release

The client agrees, via this release, to allow Total Health Concepts carry out counseling and assessment services in its various capacities as a health professional.

Nutrition Assessment Form

Our nutrition assessment form helps us understand your unique medical makeup a little better so that we can prescribe medication more effectively.