SFM New Patient Forms

All Patients

  1. SFM Notice of Privacy Practices (CLICK HERE)
  2. SFM Patient Information Sheet (CLICK HERE)
  3. SFM New Patient Health History (CLICK HERE)*
  4. SFM PHI Treatment Results Consent Form (CLICK HERE)
  5. SFM Financial Policy Agreement (CLICK HERE)
  6. SFM Nutritional and Herbal Supplements Notice (CLICK HERE)
  7. SFM Long Term Controlled Substances Notice (CLICK HERE)
  8. SFM Patient Lab Fees (CLICK HERE)
  9. SFM Patient Acknowledgement of Privacy Practices (CLICK HERE)
  10. SFM Medical Release #1 to SFM (CLICK HERE)
  11. SFM Medical Release #2 from SFM (CLICK HERE)
  12. Traditional Patient Packet (CLICK HERE)

*Included in Prospective I&FM Patient Forms below

Prospective I&FM Patient Forms

  1. SFM Patient Agreement Notice (CLICK HERE)
  2. SFM New Patient Health History (CLICK HERE)
  3. SFM Patient Readiness Assessment (CLICK HERE)
  4. SFM IFM Symptom Questionnaire (CLICK HERE)
  5. SFM Candida Screening Questionnaire (CLICK HERE)
  6. SFM Toxin Exposure Questionnaire (CLICK HERE)
  7. SFM Diet Recall (CLICK HERE)
  8. SFM Horowitz Lyme Score (CLICK HERE)
  9. I&FM Patient Packet (CLICK HERE)