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New Patient Intake Forms

Share your health goals with us!  Real Health Medical is a Christ centered, integrated medical wellness center partnering with clients through personalized coaching and health care from a functional medicine, root cause approach. Your protocols will include both clinical and lifestyle recommendations to restore health at the foundational level. 

Take a moment to complete the New Patient Intake form based on your main health goal:

Complete the General Intake for all health issues not related to cancer and weight loss.

General Health Intake Form

Complete the Cancer Intake if you suspect or have an actual diagnosis that you are seeking treatment for with our clinic.

Cancer Intake Form

Complete the Lock It In Weight Loss Intake if losing weight is your main goal in coming to our clinic.

Lock It In Weight Loss Intake Form

NOTE: Real Health Medical is a cash pay practice, we do not bill insurance directly for services.  However, labs can be billable to insurance depending on your plan.