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Pre-Intake Forms for Tick Borne Illnesses

For those interested in our Tick Borne Illnesses program, please click on the link below to download the pre-intake form.


Pre-Intake Form


1. Print and fill the form

2. Scan the completed form.

3. Email the scanned form to


The integrative physician will review the form and our staff will get back to you prior to setting up your appointment.