Chiropractic Lifestyle Center

Nutrition Intake

In addition to filling out the New Patient Intake Form, we will need for you to fill out some additional forms for your initial nutrition appointment.  These files are downloadable which means you can simply print them and then fill them out.  Please remember to sign where requested and bring these forms with you to your appointment. 

Protecting your personal health information (PHI) is our legal duty.  We comply with HIPAA and all other privacy protocols.  Read our complete privacy policy here

Detox Questionnaire

3 Day Diet Diary

What is a BIA?