New Patient FormsNew Patient Registration and Health History FormNew Patient Additional FormsColon Hydrotherapy Registration and Screening Health History Form Lyme Disease Questionnaire Click here to fill out MSIDS questionnaire Consent FormsCCIM General Consent FormExpedited Colon Therapy Consent Form HIPPA Privacy Authorization FormsClick here to authorize the release of your medical information and test results to someone else (like a family member).Authorization to share protected health information form Medical Records Request FormsClick here for a form you can sign, print and send to another medical provider to request your records be sent to our office.Click here to have our office send your medical records to another provider. Additional FormsOnline Referral Form
