Medical Consultation Form

Step 1:

Before your consultation, we would prefer you to complete a 5 day documented “food journal” of your child. This might seem inconvenient, but will be part of our integrative efforts to assess your child’s condition. We recommend you print the pages and keep them handy. The “food Journal” pages are the last 5 pages of the form.
Click the link below to download the Food-Mood-Poop journal document (in PDF).

Step 2:

Please fill out the beginning part of the medical consultation form before your visit.

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