You are using an outdated browser. Please upgrade your browser to improve your experience.
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
"My name is Chris. I came here a little over a month ago. I was not sleeping well, waking up constantly throughout the night from my hands going numb due to carpal tunnel syndrome. Now, I have absolutely no pain. I am sleeping through the night!! All without surgery! My husband says Dr. Ungar is a miracle doctor!! The way I am feeling now, I would say so too!! This program works and I am proof."