patient Onboarding

Let's start with your details.

Please provide your details below so we can contact you regarding your patient onboarding.

Your Top Reasons for Choosing 417 Integrative Medicine

What are your top 4 reasons for seeking care at 417 Integrative Medicine?

What providers have you seen?

What providers have you seen for your current symptoms/concerns?

Treatments or medications?

List treatments and/or medications you have tried for current concerns (if applicable).

Duration of Concerns?

How long have you been experiencing these symptoms or concerns that you would like to discuss with us?

Provider preference?

Do you have a preference on which provider in our office you see?

Anything else?

Is there anything else you would like to mention that you think may be affecting your health?

Complete Submission

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