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For those of you who wish to become a client, download and fill out the following three forms. Bring
to your appointment a recent blood test (if available), along with a diagnosis/prognosis from your primary care physician, copies of any recent labs, tests or evaluations and a letter of referral from your primary
care physician for treatment (optional).
Please do not wear perfume or cologne to your appointment.
Many of our clients suffer from allergies or high chemical sensitivities.
The first form tells you more about the Center and what we do. It is a contract for our services to you as
Naturopaths. The second form is basic information about you. Please fill out completely, including the social security number. The third form is more information about you, mostly a medical
history. Please fill out completely and as detailed as you possibly can. The last form is a metabolic assessment form.The more information you give us the more we can help you. Also, please bring a list (or medication information sheet) of
all prescription medication you are currently using.
We accept checks, cash, Master Card or Visa. Please make checks payable to JAM Naturopathics.
Until you meet with one of our Naturopaths, you are not a
client and therefore will be given no information or recommendations over the phone.
You must have
Adobe Acrobat Reader to download these three forms. If you do not, please take the link below and follow the directions to download Adobe Acrobat Reader.
Contract for Services form
Client Information form
Client History form
Assessment form
Neurobehavioral Checklist
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