Patient Forms

To the right are links to all the paperwork you will need for your first visit. Your Appointment has been scheduled under the assumption that your paperwork will have been completed prior to your appointment time.

When filling out the symptom survey form, please follow the directions carefully. Mark “1” in the box for mild symptoms, “2” for moderate symptoms or “3” for severe symptoms. If the symptom does not apply to you, leave the box blank.

Please have all of the forms completed before you come in for your appointment so she can spend the entire time allotted for you.

When you arrive for your appointment, please:

  • Bring your completed new patient forms
  • Bring your Symptom Survey form
  • Bring summary of your medical history
  • Bring any vitamin supplements you are currently taking

Your initial consultation will be $175, which includes the initial visit of 60 minutes to get all your information and the 2nd visit where we will discuss the report of findings and discuss the suggested plan moving forward. Subsequent visits are $75 unless you decide to take advantage of discounted package pricing. Please allow 1 hour for the initial consultation and 30 minutes for subsequent visits. I look forward to working with you to establish vital health in your life. If you have any questions, please call me at (949) 851-3106.

I look forward to helping you get healthy!

Our office is located at:
20311 SW Birch Street, Suite 150
Newport Beach, CA 92660