Online Forms

Click on the links below for a printable PDF of your New Patient Health History and Intake forms.  Adults will need to complete forms 1—4 and children 1 and 3—6.  

1. Patient Registration

2. Adult Patient Case History

3. Review Of Systems

4. Consent, Assignment, and Agreement

5. Pediatric Patient Case History

6. Consent for Treatment of a Minor

Haga clic en los enlaces a continuación para acceder un PDF imprimible de los formularios. Necesita completar los formularios 1—4 para adultos; 1 y 3—6 para niños.

1. Registro del Paciente

2. Historia Clínica del Paciente

3. Revisión de los Sistemas

4. Consentimiento, Asignación y Acuerdo

5. Historia Clínica Pediátrica

6. Consentimiento para Tratamiento de un Menor de Edad

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SIGN UP USING THE FORM OR CALL US TODAY AT 913-839-2389 TO SCHEDULE YOUR APPOINTMENT

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Office Hours

Our Regular Schedule

Balanced Body Holistic Health

Monday:

8 - 1

3-6

Tuesday:

8 - 1

3-6

Wednesday:

8 - 1

3-6

Thursday:

8 - 1

3-6

Friday:

Closed

Closed

Saturday:

Closed

Closed

Sunday:

Closed

Closed