Additional forms · only if requested
Forms the office may ask you for.
Most patients never need this page. Your new patient history is completed online, and the team will tell you if you need anything here. If they have, download the form, fill it in, and bring it to your visit or email it to info@winterswellness.com.
Your new patient forms
The usual path is online: complete your new patient history here. It saves as you go, and the doctor reads it before you arrive. The printable versions below are for the rare case the online form does not work for you.
Downloadable forms
-
Adult New Patient History Form
Print-and-sign version of the new patient history. Use only if the online form did not work for you. 7 pages.
-
Pediatric History Form
For patients 16 and younger. Use only if the online form did not work for you. 2 pages.
-
Brain Localization Form — print version
Fill in by hand and bring it with you. 3 pages.
-
Brain Localization Form — digital version
Fillable PDF: complete it on your computer, save, and email it to info@winterswellness.com.
-
Metabolic Assessment Form
Complete only if the office has asked you to. 2 pages.
-
Patient Records Release Form
Authorizes another provider to send your records to us, or us to send yours on. 1 page.
-
Notice of Privacy Practices
How your health information is used and protected. For your records; nothing to sign.
Sending records
If you have recent lab work, imaging or reports, getting them to us 24 hours before your visit lets the doctor prepare. Fax (270) 554-8795, email info@winterswellness.com, or bring them with you.