Tricho-Wellness Consultation Forms
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 within 24 hours of the scheduled appointment time. This will provide Dr. Candy time and an opportunity to review your information prior to meeting with you. By doing so, our hope is to save you extra consultation fees or sessions.
INSTRUCTIONS:
Schedule your appointment by going to Schedule & Payment.
Thank you in advance for your time and effort in completing these forms. We do hope you consider our programs to find your own ANSWERS, RESULTS & HOPE.
Tricho-Wellness Questionnaire
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.
Assumption of Risk and Release of Liability
The Lotus Concept Wellness
