Optimized Wellness Center offers our patient forms online so they can be completed in the convenience of your own home or office.
- If you do not already have AdobeReader® installed on your computer, Click Here to download.
- Download the necessary forms from the list below that pertain to your visit, print them out and fill in the required information.
- Submit them via email 24 hrs prior to your first appointment.
Practice Member Application*
*This lets us know the history and current state of your health. What questions, concerns, or goals regarding wellness can we help you with? We need this in advance of your appointment so we can help you best. Let us know!
Medical Release Form
*This allows us to send or request medical records to or from another provider. What specific records do you need shared, and with whom? Just fill this out and we’ll take care of it.
Privacy of Practices
*This explains how your health information is protected and your rights under HIPAA. Want to know how we keep your information safe and private? Take a look here.
Practice Member Re-Evaluation
*This helps us reconnect and understand how your health has changed since your last visit. What’s improved, shifted, or still needs attention? We’d love to hear where you’re at now.
Lab Testing Preparation
*This walks you through how to prepare for upcoming lab work. Are you fasting? Staying hydrated? Taking any supplements? Make sure you’re fully prepped for accurate results.
Telemedicine Form
*This gives consent for remote visits when you’re meeting with us virtually. Do you prefer the comfort of care from home or need flexible options? This form helps make that possible.
Short Intake Form for Therapies
*This helps us check in with you before any wellness therapy sessions like LLLT, PEMF, WBV or LED. How are you feeling today? Anything new we should know before we begin?