Use the links below to download all forms:

Bring a list of your current medications.

Be sure to fill out the intake form as thoroughly as possible.

If you have any questions feel free to give us a call!


***NOTE: If you are filling this form out on your computer, it must be opened in Adobe to be able to be signed. If you are filling it out on your web browser than you must still print out to sign where necessary.  

Patient Intake Form



Ozone Informed Consent



Beginning October 1st, 2022 all New Patients will be required to leave a $50.00 deposit.

Complete the Ozone Informed Consent Form ONLY if receiving Ozone Therapy including Chelation/Prolozone.

All therapies are MD ordered and supervised and RN administered in the state of NY