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New Patient Forms

We offer our paperwork online so you can complete it in the convenience of your own home. Call us or Click here to email us your questions!


Confidential Patient Information – Initial Consultation

These forms let us know what’s happened, but perhaps more important, where do you want to take your health? Please also take the time to accurately fill out the Metabolic Assessment and Neurotransmitter Assessment forms. It provides us with a lot of information to make certain you get the best results possible.

Adult New Patient Forms

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Pregnancy – New Patient Questionnaire

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Pediatric Intake Form

This information will help us determine how to best help your child. Please also fill out the Child Neurotransmitter and Nutrition Questionnaire below.

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Child Neurotransmitter and Nutrition Questionnaire

This information will tell us the nutritional status and neurotransmitter status of your child.

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Free AdobeReader®

Get adobe readerEach form is a PDF document file. If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.


Family Focus Wellness Center | (903) 236-6222