New Patient Intake Forms
 

All forms are downloadable pdf's. Please use Adobe Acrobat Reader to print for your use.
You will need all five forms. Please return to Namaste Health Center at the address below,
prior to your first visit. Thank you.

The Health Status Interview is a live pdf form. Download it, then fill it out on your computer, using Apple Preview or Acrobat Reader and then save it... Then email it back to us.

Email here: info@namastehealthcenter.com
   
  Health Status Interview (11pages) fill out & return
   
  Financial Policies (1 page) sign & return
   
  Patient Consent Form (1 page) fill out & return
   
  Ackn. of Receipt of Privacy Practices Notice (1 page) fill out & return
   
  Privacy Practices Notice (2 pages) keep
     
  Pediatric Health History (3 pages, for children) fill out & return