Health Forms

If you have already scheduled a consultation or are an existing client, click the following links to fill out your Health History or Revisit Form.

For your first session with me, please download and complete the appropriate Health History form below.

Women Health form - pictureWomen’s Health History form Women’s Health History









Men Health form - pictureMen’s Health History form Men’s Health History form








Revisit FormBefore your next session with me, please fill out the Revisit form

Revisit form
Laila Heidema – Revisit Form

Instructions: right click (with your mouse) to save as…then fill out the form and email it to me.