Initial Intake - Integrative and Holistic Medicine with Dr. Kathy Veon 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal information in the designated fields, including your name, date, address, and contact details. Ensure accuracy for effective communication.
3. Complete the emergency contact section by providing a name and phone number. This is crucial for any urgent situations that may arise during your visit.
4. Fill out the medical history section thoroughly. Include past treatments like acupuncture or nutrition therapy, current medications, and any significant illnesses. This information helps Dr. Veon tailor your treatment plan.
5. Review the lifestyle questions carefully and check all applicable boxes regarding habits such as tobacco use, exercise frequency, and dietary preferences.
6. Finally, sign the consent forms at the end of the document to acknowledge your understanding of the policies and treatment risks before submitting your completed form.

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