Patient Information Form


New Patient Information Form

  1. Chronic Initial
  2. Acute Initial or Musculoskeletal

Dr Debbie Smith patient intake documents

Dr Debbie Smith

Dr Debbie Smith

1.  Chronic Initial Patient  – Condition longer than 3 months

Download both documents
The forms should be emailed back to the practice before your appointment – ideally 24 hours before your appointment. Email to:


  • Dr Debbie - Health Assessment Questionnaire
    Dr Debbie - Health Assessment Questionnaire

    The Health Assessment Questionnaire will take about 30 minutes to complete. Please complete at least 24 hours before your appointment. Questionnaires not completed on time will not be discussed.  Keep and save file in excel format when emailing  back

    Complete if you want to get to the bottom of your problem, find out your nutritional deficiencies and see what area of your body would be best to address first for improving your health



Musculoskeletal Initial Patient &  Acute Initial Patient  – Condition less than 3 months





DR SANDRA SQUARA new patient documentation