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Intake Forms

Please review the forms and requests below. These forms are also available in the Patient Portal. 

NGI and GenMedx Systems Medicine Intake 

This is our primary intake form - please complete this 3 days prior to your appointment. 

Who doesn't need to complete the System's Medicine Intake?

If you are a Medical Cannabis Candidate, Please complete the following forms: Neurotransmitter Assessment; PC-PTSD-5; Pain and Dysfunction; Depression and Anxiety Symptoms; Medical Symptom; Symptom Review and Mood Disorder Forms.  

 

If you are doing our introductory mini diet panel and nutrition appointment please complete the following questionnaires: Medical Symptoms; Symptom Review; Digestion; Metabolic Assessment Form, Thyroid; Blood sugar and Insulin Resistance and Readiness Assessment. 

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*These are found in the Questionnaire tab in the patient portal. You do NOT need to complete the System's Medicine Intake Form. 

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