Skip to content

Functional Medicine Paperwork

Please set aside some time to complete the new patient packet below. Please note: It may take an hour or so to complete the required paperwork. This information will provide the doctor with a better picture of your past and current health and will greatly increase the efficiency of your visit. If you do not have access to a printer, please call the clinic and we will be happy to send you a copy in the mail. Be sure to complete steps 1 and 2 before your first visit.

1. Print and complete the appropriate new patient packet below.


2. Send the completed new patient packet to us at least 24 hours before your appointment.

OFFICE HOURS


Monday
9:00am - 5:30pm


Tuesday
9:00am - 5:30pm


Wednesday
9:00am - 5:30pm


Thursday
9:00am - 5:30pm


Friday
9:00am - 5:30pm


Saturday
9:00am - 11:00am

One Source Wellness & Chiropractic
13730 West Greenfield Avenue
Brookfield, WI 53005
(262) 244-7600

Buy Lauricidin Original Monolaurin Supplement at My Shop
Scroll To Top