Midwest Functional Health offers our patient forms online so they can be completed in the convenience of your own home or office.
- If you do not already have AdobeReader® installed on your computer, click here to download.
- Download the necessary form, print it out and fill in the required information.
- Bring your completed form with you to your initial consultation.
History Form & Neurotoxic Questionnaire
This form will give us an idea of your personal history and how neurotoxic your body is. Please fill it out and bring with you on your first visit.