ATTACHED FORMS:

 

  • Patient Information Form (PDF)
  • Horowitz Lyme-MSIDS Questionnaire (PDF)
  • Health History (PDF)
  • Fasting Primer Instructions (PDF)
  • Informed Consent For Consultation (PDF)
  • Low Mold Diet Instructions (PDF)
  • Consent for Injectable Treatment (PDF)
  • Consent Nucleoskin Topic (PDF)
  • Informed Consent for Consultation (PDF)
  • Consent PRP (PDF)
  • Healthy History (PDF)
  • Electronic Communications Agreement (PDF)
  • Consent for Treatment with PDO (Polydioxone) Suture Threads (PDF)
  • Consent for Undergoing Activated Oxygen Therapies with UBI Therapy (PDF)
  • Authorize to use or Disclose (Release) Health Information that Identifies you for a Research Study (PDF)