Healing Traditions Integrated Wellness    
     7114 W. Jefferson Ave. Suite 208      Lakewood,      Colorado      80235    
   Phone: (303) 997-9414    URL of Map 
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Patient Forms Download

 

New Patients -

 

1. Please print and fill out the following forms:

1. Acknowledgment of Privacy

2. Cancellation Policy

3. CO Mandatory Disclosure Statement

4. Consent to treat form

5. Informed consent to use disclosure of Health info

6. Health History

7. Metabolic Assessment Form (MAF) - For Patients With Internal Issues*

8. Neurotransmitter Assessment Form (NTAF) - For Patients With Internal Issues*

 

Bring the completed forms to your first appointment.

 

*NOTE: Musculoskeletal issues can mean an injury or bodily aches and pains.  Internal Issues are issues within the body, beyond the musculoskeletal system.

 

 

2. Click here to download and review:

1. New Patient Welcome Letter

2. Notice of patient privacy
 

 

3. Fertility and ART (Assisted Reproductive Technology) Health History forms:

1. Fertility Intake

 

www.FertilityFriend.com

The website we recommend for charting your Basal Body Temperature & Menstrual Cycle



 

 

The road to conceiving a child can be difficult for patients suffering from fertility hurdles. Fortunately, the best of both worlds in the field of

If you are ready to take charge of your health and start living your Healthiest and Best life, Full of Vitality, Vigor and Wellbeing, please contact us at 844-739-HEAL(4325) or complete the Become a Patient Form.

 

American Board of 
Oriental Reproductive Medicine

Certified Practitioner

National Certification
Commission for Acupuncture
and Oriental Medicine

Certified Practitioner

 

 

 

natural fertility supplements

 

 

 

Guided Audio-MP3 Meditations to support

Female Health and Fertility