Tricho-Wellness 15 Min. Consultation Form
Tricho Consultation Form Instructions :
We are a paperless practice; our website, email and virtual conferencing platform are secure for conferencing, payment and the transmission of your records and information. If you have questions please don't hesitate to give us a call.
All clients must complete the following forms and return them prior to their scheduled appointment time.
Schedule your appointment by going to Schedule & Payment.
We do hope you consider our programs to find your own ANSWERS, RESULTS & HOPE.
My Story
Instructions:
Your Story
The purpose of this form is for you to give a little more background information about yourself, condition, etc.
In your own words please tell me "your story". Take as much space as you need. Please include the follow:
- When did your health challenges begin and how long before you sought help?
- Did you get a diagnosis and medication? If so, what was the diagnosis, how often have your medications and dosages been changed?
FYI: It's most helpful if the information is given in a timeline formate.
Tricho-Wellness Informed Consent
The Lotus Concept Wellness
