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    • Home
    • About
    • What I do
    • Book Appointment
    • Client Forms
    • Order Supplements
    • Contact
    • Products I like
  • Home
  • About
  • What I do
  • Book Appointment
  • Client Forms
  • Order Supplements
  • Contact
  • Products I like
Functional Rootgenics

New CLIENT Forms

Please download and print all new patient forms, fill them out and submit them by email at least 3 days prior to your appointment to andrea@functionalrootgenics.com

Authorization for Use and Disclosure of Protected Health Information (pdf)Download
Notice of Understanding and Agreement (pdf)Download
Nutritional Informed Content (pdf)Download
Nutritional Assessment Questionnaire (pdf)Download

Disclaimer

The information on this website has not been evaluated by the FDA and is not intended to treat, cure, or prevent any disease.


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