Patient Forms: Center For Integrative Medicine - Balancing the Best of Complementary and Alternative Medicine

Please Download, Print Out, Fill Out and bring the appropriate form(s) to your First Appointment.

The following forms are in PDF File Format.
A PDF reader should already be on your computer, but if you need to download one you can click here to go to the Adobe PDF Reader. It is free.

Medical History Form

Records Release Form

Patient Information Form

Authorization For Treatment Form

Dr. Sullivan-Durand's Integrative Medicine Evaluation Form

Dr. Sullivan-Durand's MicroCurrent Evaluation Form

Dave Berger's New Patient Intake Packet