New Patient Intake Paperwork
Welcome to Our Wellness Center
Thank you for choosing our office and allowing us to help you in this time of need. We help sick people get healthy and healthy people stay that way. Our purpose is to help as many people as possible and it is an honor each time we are asked to improve a person’s health and we take our role as your healthcare provider very seriously. Our patients’ confidence in us drives our commitment to provide the highest quality care possible to them and their families. We have helped many types of patients with many different symptoms and levels of health. We help our patients to find answers to their health problems and if you are accepted as a patient, we hope to do the same for you. The process of identifying the exact, correct underlying CAUSE of your problems requires a great deal of information and testing. That process begins with filling out our New Patient Application Forms. Please take your time and fill the forms out completely and thoughtfully. The doctor will meet with you to discuss your condition and do an examination. Based on what the doctor learns, special tests may be ordered like x-rays, MRI's, or advanced metabolic tests. If directed by the doctor your visit may end with some therapy to help provide you some temporary relief. The doctor will review the information learned from the consultation, examination and prior testing to determine if you are accepted into our office. Everything will be explained to you on at your visit.
We do not accept all cases. If we feel we can help you, we will explain your treatment options. If we feel we cannot, we will help you find someone who can. Again, we look forward to serving you. If you have any questions, please do not hesitate to ask.
Thank you for choosing our office and allowing us to help you in this time of need. We help sick people get healthy and healthy people stay that way. Our purpose is to help as many people as possible and it is an honor each time we are asked to improve a person’s health and we take our role as your healthcare provider very seriously. Our patients’ confidence in us drives our commitment to provide the highest quality care possible to them and their families. We have helped many types of patients with many different symptoms and levels of health. We help our patients to find answers to their health problems and if you are accepted as a patient, we hope to do the same for you. The process of identifying the exact, correct underlying CAUSE of your problems requires a great deal of information and testing. That process begins with filling out our New Patient Application Forms. Please take your time and fill the forms out completely and thoughtfully. The doctor will meet with you to discuss your condition and do an examination. Based on what the doctor learns, special tests may be ordered like x-rays, MRI's, or advanced metabolic tests. If directed by the doctor your visit may end with some therapy to help provide you some temporary relief. The doctor will review the information learned from the consultation, examination and prior testing to determine if you are accepted into our office. Everything will be explained to you on at your visit.
We do not accept all cases. If we feel we can help you, we will explain your treatment options. If we feel we cannot, we will help you find someone who can. Again, we look forward to serving you. If you have any questions, please do not hesitate to ask.
Our Intake Paperwork is available in an online fillable format. You will receive a link to complete the Intake Paperwork when your initial case review is scheduled.
This is the preferred method to submit your health history.
The information below is for those who would rather complete the intake on paper.
Adult Paperwork
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| Adult New Patient Health History |
Pediatric Paperwork
(Autism / ADD / ADHD)
(Autism / ADD / ADHD)
| Pediatric New Patient Health History |
Please print and complete the following application completely prior to your scheduled appointment
in order for us to determine if you or your child are a good candidate for our care.
in order for us to determine if you or your child are a good candidate for our care.
Please have the New Patient Application Forms completed BEFORE your initial visit. Please submit all paperwork and previous lab testing (past 6 months) prior to your initial visit. This allows the doctor to familiarize themselves with your case and do any needed research before your visit.
Please submit via:
1) Email: info@anhcg.com
2) Fax: (321) 218-9898
3) Mail (if there is sufficient time):
Advanced Natural Healthcare & Genetics
Attn: New Patient Coordinator
7777 N. Wickham Road, Ste 12-238
Melbourne, Florida 32940
Confirming Your Appointment
You will receive a confirmation reminder one business day prior to your appointment. If we fail to reach you, please leave a message at (678) 324-6963 or email us confirming the appointment at info@anhcg.com.
If you would like your appointment to be moved to an earlier date, let us know and we will call you if there is an opening.
Please submit via:
1) Email: info@anhcg.com
2) Fax: (321) 218-9898
3) Mail (if there is sufficient time):
Advanced Natural Healthcare & Genetics
Attn: New Patient Coordinator
7777 N. Wickham Road, Ste 12-238
Melbourne, Florida 32940
Confirming Your Appointment
You will receive a confirmation reminder one business day prior to your appointment. If we fail to reach you, please leave a message at (678) 324-6963 or email us confirming the appointment at info@anhcg.com.
If you would like your appointment to be moved to an earlier date, let us know and we will call you if there is an opening.