The following forms are double sided to help conserve paper, please set your printer to duplex printing.  If you don't have this option available the forms will print single page.  At the end of each of these intake forms is a terms of agreement, acknowlegement of privacy, and insurance policy, please be certain to sign each of these.  Thank you.

1.)  Adult New Patient

2.)  Pediatric New Patient

3.)  Infant New Patient

The following forms are West Valley Naturopathic Center's Insurance policy and a copy of our Private Practices. These forms are also double sided.

1.)  Insurance Policy

2.)  Copy of Private Practice

The following forms are to better assist your physician in tracking a variety of useful information. 

1.)  Blood Pressure Monitoring

2.)  Medication List

3.)  Release of Records

4.)  Request of Records