The Whole Health Center - iHEALTH RECORDS

OFFICE FORMS

New patient form

This form provides us with your medical history. Your thorough completion of this form will enable us to work more efficiently during our time together and will allow a means by which to reassess your status on future visits. It is important for you to complete these pages as accurately and as completely as possible.

To download and complete the form:

1. Right click on the following button then "Save Target As..."

2. Save the blank document to your desktop. (Please note: Saving the form to your desktop is an important step -- if you fill it out within your browser window, all your work will be lost).

3. Open and complete the form using Microsoft Word.

4.

If you have problems downloading or emailing the form, please call (713) 840-9355 or send an email to for assistance.