top of page
PATIENT FORMS
For the convenience of our new patients, the paperwork needed for your first visit can be found below.  You have two options for completion:

Please note: We are currently only accepting new patients for thyroid nodule biopsy, RFA (radiofrequency ablation), or PEI (percutaneous ethanol injection).
Type.png
TYPE
YOUR RESPONSES

Click the link(s) below and open the form(s) in Acrobat. Chose File>Save As... to save the form(s) to your hard drive before completing, otherwise your typed responses will not be saved. Be sure to print all completed forms and bring them to your appointment.

Write.png
ï…‹ï…‹WRITE
YOUR RESPONSES

Click the link(s) below. When the PDF opens, click the print icon in the upper right-hand corner. The Print Dialog box opens. Under Destination, choose your printer and then click the print button at the bottom of the dialog box. Fill in your answers and be sure to bring your completed forms to your appointment.

​

Download ALL New Patient Forms at Once

All New Patient Forms

 

OR Download Individual Forms

Personal Information

Welcome Letter

Personal History

Consent for Evaluation or Treatment

Acknowledgment of Receipt of Privacy Practices

Notice of Privacy Practices

Food diary

 

The Metabolic Center for Wellness charges all patients an annual fee of $195.  The annual fee covers the practice

enhancements and access that are not covered by insurance.  All medical visits will be billed separately.

​

Please feel free to call our office if you have any questions.

 

Thank you in advance for your cooperation!

bottom of page