To begin the registration process, new patients are required to complete a series of five forms, starting with the Patient Acceptance Policy Form. Upon completion of each form, a link will automatically direct you to the next one. If you need to pause at any time, simply finish the current section of the form and exit safely. When you’re ready to continue, simply click on the appropriate button below to pick up where you left off.

Hometown Integrated Medicine New Patient Form: Part 1 – Patient Acceptance Policy

Hometown Integrated Medicine New Patient Form: Part 2.1 – Health Questionnaire

Hometown Integrated Medicine New Patient Form: Part 2.2 – Health Questionnaire

Hometown Integrated Medicine New Patient Form: Part 2.3 – Health Questionnaire

Hometown Integrated Medicine New Patient Form: Part 2.4 – Health Questionnaire

Establishing Health Goals

Environmental Influences

Nutrition and Lifestyle

Authorization for Release of Medical Records

Attachments