Patient Center

Please find below a questionnaire to download, print, fill out and bring to your office visit. If you cannot do so, please come to your appointment 20 minutes before to fill out the questionnaire in the office. Please bring your supplements, a list of medications you are presently taking, and most recent diagnostic reports. You may also ask you doctor to fax you most recent laboratory results to us. Our fax number is 845-943-4483

CONFIDENTIAL HEALTH HISTORY QUESTIONNAIRE

Please find below a questionnaire to download, print, fill out and bring to your office visit. Please bring your supplements, a list of medications you are presently taking, and most recent diagnostic reports.

Adult Questionnaire

Child Questionnaire

INSURANCE

Download this useful questionnaire to find out if your insurance will reimburse the cost of services.

Insurance Questionnaire

MEDICINARY

You may stop by the office during regular business hours to pick up your supplements, however it is always best to call before you do so. If we do not have the item you need, we are usually able to order it within a week. As a general rule please call one week before your supplement runs out, so we may make arrangements for you to pick it up.

LABORATORY WORK

To ensure the highest standard of care, laboratory results are reviewed and released only during an office or telehealth visit, where we can properly explain findings and discuss next steps. Laboratory kits are provided exclusively to established patients and require payment at the time of the visit. Please note that testing kits must be completed and returned within three (3) months of issuance; kits not completed within this timeframe will result in forfeiture of associated fees.

HORMONE PANELS:

Dutch Test

Video | Dutch Test Explained

How to Collect the Dutch Test

Sample Report

Adrenal Stress Index

Sample Report

FOOD INTOLERANCE PANELS:

Sample Reports

96 IgG General Intolerance Panel

96 IgG Vegetarian Intolerance Panel

144 IgG Intolerance Panel