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Patient Name:___ DOB:___Intake form, 1Welcome. Our philosophy and approach to medicine is wholistic and seeks to understand all factors that may be affecting your health. This intake form will help
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Start by providing your personal information such as name, date of birth, address, and contact information.
02
Fill out your medical history including any current health conditions, past surgeries, medications you are currently taking, and any allergies.
03
Specify your reason for visit and any symptoms you are experiencing.
04
Answer any additional questions regarding your lifestyle, habits, and preferences that may be relevant to your treatment.
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Sign and date the form to confirm all information is accurate and complete.

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Anyone seeking treatment or consultation at UF Health Integrative Medicine would need to fill out the patient intake form. This form helps the healthcare providers understand the patient's medical history, current health status, and treatment needs in order to provide the best care possible.
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The uf-health-integrative-medicine-patient-intake-form is a form used by patients to provide their personal and medical information prior to their appointment with the UF Health Integrative Medicine department.
Patients who have scheduled an appointment with the UF Health Integrative Medicine department are required to fill out the uf-health-integrative-medicine-patient-intake-form.
Patients can fill out the uf-health-integrative-medicine-patient-intake-form either online through the patient portal or by completing a paper form at the clinic.
The purpose of the uf-health-integrative-medicine-patient-intake-form is to gather necessary information about the patient's medical history, current symptoms, and other relevant details to assist the healthcare providers in providing the best possible care.
The uf-health-integrative-medicine-patient-intake-form typically includes sections for personal information, medical history, current medications, allergies, and specific symptoms or concerns that the patient wants to address during their appointment.
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