Fwlpaperwork com 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Section 1 by entering your Name, Date of Birth (DOB), and Today's Date. Fill in your Address, City/State/Zip, Best Contact Phone Number, and Email. If you are a new patient, ensure all fields are completed.
3. In Section 2, rate your overall health, diet, and motivation on a scale of 1-10. Provide specific details on what changes you need to make to achieve a perfect score.
4. Proceed to Section 3 where you will list current prescription medications, over-the-counter medications used frequently, and any supplements. Indicate any family history of high blood pressure, diabetes, cancer, or autoimmune issues by checking the appropriate boxes.
5. In Section 4, provide your present weight and height. Indicate if you've tried other weight loss programs and specify desired weight. Note how often you eat out and any food allergies.
6. Finally, acknowledge receipt of HIPAA Privacy Practices by signing at the bottom of the form along with the date.

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