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Attached is our New Client Intake and Lifestyle Form. At first, this form may seem very long and, in fact, it may take you awhile to complete it. However, every piece of this information is important. The doctors need to know as much as they can about you in order to put together your health and wellness puzzle and develop a treatment plan that is specific to you.
Please click here to download the form and print it. You can them email the completed form to firstname.lastname@example.org, fax it to (330) 644-9292 or (216) 236-0067 or mail it to the office in which you have your appointment:
Akron: 2800 S. Arlington Road, Suite 100, Akron, Ohio 44312
Cleveland: 6200 Rockside Woods Blvd., Suite 100, Independence, Ohio 44131
We hate spam as much as you do and will not share or rent your personal information to any third party.