Physician Consultation Forms
This Registration Packet must be completed prior to any form of therapy. It is due at least seven (7) days before the appointment.
1. Patient Registration form
2. Financial Policy Agreement – please contact the office for an updated copy
3. Disclaimer and Informed Consent
4. Notice of Privacy Practice
5. Child 26-page Autism Questionnaire
6. Adult Medical Questionnaire
7. Adult Exposure History Form

Metabolic Detoxification
• Detoxification Questionnaire

Hyperbaric Oxygen Therapy
• HBOT Informed Consent
• HBOT Office Policies

Intravenous (I.V.) Therapy
• Intravenous Therapy Informed Consent

XLR8 Cold Laser Therapy
• XLR8 Informed Consent

Verju Body Contouring
• Verju Informed Consent
• Verju Marketing Consent Form

TempSure Therapy / Non-surgical Face Lift
• TempSure Informed Consent
• TempSure Medical Questionnaire
• TempSure Marketing Consent

Religious Exemption
• Religious Exemption form