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Patient Intake Form - (Functional Medicine)-IQ

Patient Intake Form - (Functional Medicine)-IQ


Patient Intake Form (Functional Medicine)

(IQ Format)


This is the form that patients fill out before seeing their provider.  It is mapped and pinned to the accompanying note template.   This means that the intake form and the note template "talk to each other" decreasing your charting time.   This form should be purchased with its accompaning note template ________________


This form was created using (8) insurance documentation audit tools and is highly comprehensive.


This form is heavily ruled to make it show consents, add tags to charts and trigger processes.  You will recieve a video that tells you how to edit it if you need to make edits to this form and/or the note template.  This will allow you to understand how the form works.

  • Please Read and Understand These Terms Carefully Before Making a Purchase on Our Website. By Proceeding With a Purchase, You Indicate Your Acceptance of the Terms Outlined Below:


    Refunds: If you choose to request a refund for reasons other than a fault in our services, we will refund the purchase price. However, please note that the refund will be less the processing fees for both the purchase and refunding operations.


    Processing Fees: Processing fees refer to the costs associated with conducting the financial transactions on our website. These fees are non-refundable under any circumstances.


    Fault in Services: If the refund request is due to a fault in our services, we will take full responsibility and ensure that you are compensated appropriately. In such cases, the processing fees will be waived.


    Forms Purchases: Due to the electronic nature of our forms, there are no refunds after purchase. We are not attorneys. Our forms have been created by healthcare professionals not attorneys. Any copyright needed on forms are the responsibility of the purchaser.


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