Naturopathic Family Medicine, LLC

Please complete the appropriate forms before your appointment.  Please note that the adult intake is extensive and may take 30 minutes or more to complete. It is most helpful for Dr. Robin to receive the completed intake form at your first visit.

If you are coming to see Dr. Robin for Lyme treatment or evaluation, please also complete a Lyme Symptom Checklist.

Lastly, please bring recent lab test results (up to one year prior to your appointment) and a complete supplement and medication list (with ingredients) to your first appointment.

Adult Intake (pdf)

Pediatric Intake 0-5 (pdf)

Pediatric Intake 6-17 (pdf)

Lyme Symptom Checklist (pdf)