Forms

The following forms are available for download.

These forms are intended for patients of Cedar Avenue Integrative Medicine. Please click on the link to download the forms. You may fill out the forms on your computer or print them and fill them out by hand. Please bring the appropriate forms with you to your appointment for a quicker visit with our practitioners.

 Consent for Treatment Form ( download )
As a patient of Cedar Avenue Integrative Medicine, this form will allow the practitioners of Cedar Avenue Integrative Medicine to treat you and your family.
 Financial Policy Form ( download )
This form states your agreement to follow the rules of payment for treatment at Cedar Avenue Integrative Medicine.
 Privacy Practices Form ( download )
This form states your consent for contact and what level of Privacy you elect to maintain in your correspondence with Cedar Avenue Integrative Medicine.
 Pediatric Intake Form ( download )
This is a health history form specifically for pediatric care of your children.
 Newborn Intake Form ( download )
This is a health history form specifically for pediatric care of your newborn child.
 Female Intake Form ( download )
This is a health history form specifically for female patients of Cedar Avenue Integrative Medicine.
 Male Intake Form ( download )
This is a health history form specifically for male patients of Cedar Avenue Integrative Medicine.