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To Use: Open and download the documents. Save to your computer. Add your logo to the header and your contact info to the footer.

If you have any issues downloading these documents, click here for the Dropbox folder

Forms

General Intake Form – Print

General Intake Form – Online

Women’s Hormone Questionnaire

Menopausal Women’s Hormone Questionnaire

Men’s Hormone  Questionnaire

Results Tracker

Decisional Balance Form

Challenging Catastrophic Thinking Form

Master Protocol Chart – February 2022

Questionnaires: This is a disclaimer you can use with clients so they can understand the purpose of the questionnaire:

The questionnaire is not for diagnostic purposes. It is a tool to help illustrate how different areas of the body are interconnected and how that may affect various hormones, resulting in symptoms you may be experiencing.