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The IMC Balance of Health

IMC PDF Forms:

Patient Registration

Health History - Drs Dozor, Barnett, Pettit

Chiropractic Intake 1
(1 of 2)

Chiropractic Intake 2
(2 of 2)

Naturopathic Intake - (Adult)

Naturopathic Intake - (Child)

Auto Accident Form

ABC Membership Agreement

Care Conference Personal Health Survey

Medicare ABN

Patient Records Request

How IMC Works
IMC Forms

Welcome

We appreciate you taking the time to review the forms and information needed for your visit at Integrative Medical Clinic. We are here to serve your health care needs. If you have questions or difficulties, please use the contact us button.

For your first appointment with a new provider at IMC we recommend completing your forms BEFORE you come to the clinic. This will give you more time with your provider.

New patient forms for physician appointments will take about 30 minutes. All new patients to the clinic need to complete the Patient Registration form. For appointments with Drs. Dozor, Barnett, or Nichols please also complete the Health History form. For forms completed on line, we accept typed signatures.

Forms can be completed on line or printed out and completed by hand. Be sure to save a copy of your completed form for your files.

The Steps to Complete Your Forms:

Check the list of forms on the left hand menu on this page

Click on the form you need to complete and a PDF file will open on the screen, or you will be asked to be download it to your computer.

COMPLETE the form – either ON-LINE (you can type in the blanks on some forms), or PRINT the form and complete it in writing.

Save the completed form, either to your computer files or by making a copy.

Choose One of the Following 3 Options for Getting the Form to IMC:

Send IMC an email and attach the completed form from your computer files. Or -

Print out the completed form and fax it to IMC at (707) 284-9204. Or -

Print out the completed form and bring or mail it to IMC for your appointment.

Become a Certified Navigator 

Integrative health is developing a new profession. Individual & group training is starting at IMC. Visit the Training Programs page in the Education Center.


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