NUW Intake Forms

To save time, we have made our intake forms available here for download and printing. You will need Acrobat Reader to view the forms.

Naturopathic Consultation, Weight & Wellness, General Wellness: (Dr, Patti or Shari)

  • NUW Client Intake Form for first-time Naturopathic or Wellness Consultations. We will email you the forms for Brainergy Optimization as needed.


  • PEMF Intake Form for Pulsed Electromagnetic Field Therapy (please also complete PEMF Consent Form Waiver below).
  • PEMF – Consent Form Waiver for Pulsed Electromagnetic Field Therapy (please also complete PEMF Intake Form above).

Thermography clients, please complete the following:

Compassionate Breakthrough: 


Please bring the forms with you to your appointment or email them to We look forward to seeing you soon!

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