Intake Forms

There-Is-A-Lot-Of-Paperwork-to-Fill-Out-For-the-K-1-Petition-2Below are PDFs of the intake and legal forms you will need to complete and bring to your first appointment. You may also send them ahead of time by uploading them into our patient portal. There are 5 Intake forms. It will take you about 45 minutes to complete them all. Please be sure all pages have printed!

 

1: Basic Health History Intake (7 pages) health_history_intake_form

2: Basic Ayurveda Intake Form (2 pages) prakriti-vikruti-self-intake-sept2016

3: Digestion/Toxicity/Immunity Form (2 pages) Agni_Ama_Ojas_Assessment

4: Daily Routine Intake Form (1 page) Ayurveda_Daily_Routine_Intake_Form

5: Chinese Medicine Symptoms Intake Form (2 pages) TCM Symptoms Intake Form

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For those who have already had an initial Ayurvedic assessment, you can always take this Imbalance Quiz to see how you are progressing. The fewer boxes you check, the less imbalance you are experiencing. Please contact bardoacupuncture@gmail.com if you have any questions:

Ayurvedic Imbalance Quiz: Imbalance quiz stand alone PDF