Dr. Lisa Smith, ND
Below are links to the adult (13+ years of age) and child (0-12 years of age) intake and consent form packages. The intake portion of the respective form should be completed prior to the start of your initial consultation to avoid delays in starting the intake process. This intake form will provide a baseline of information that will start our conversation for each concern to be further explored. The consent/policy portion of each document should be reviewed prior to your first visit, however I request that you reserve signing them until we have discussed their content and I have answered any questions you may have. If you choose, you can print the appropriate form and complete it ahead of time, or you can arrive to the clinic 15-minutes prior to the start of your visit to complete it there.
Adult Intake and Consent Form Package
Child Intake and Consent Form Package
Diet Diary: you can use this document track your dietary intake, symptoms/health concerns, activity and sleep for 1 week prior to the visit as a helpful means to identify patterns that may be impacting your health.