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"Autism is a treatable condition requiring much patience, understanding and love" Dr K. Ferraro !

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Patient Forms

Our ability to draw effective conclusions about your present state of health and how to improve it depends, to a significant extent, on your ability to respond thoughtfully and accurately to both these written questions and those posed by the clinician during your consultations. Health issues are usually influenced by many factors. Accurately assessing all the factors and comprehensively managing them is the best way to deal with these health challenges. Your careful consideration to the questions contained in the forms below will enhance our efficiency and will provide for more effective use of your scheduled consultation time. These questions will help to identify underlying causes of illness and will help us formulate a treatment plan. Please take the time to print them at home and bring them with you to the office.

Adult Intake Forms
Acupuncture Consent - Form Acupuncture Consent
Adult Consent - Form Adult Consent
Medicare Contract - Form Medicare Contract
Adult Intake - Form Adult Intake
Functional Medicine Info Working With the Doctor
Supplement-Consent-Form Supplement Consent
Privacy_Form Privacy-Form
Medical Follow Up Medical Follow Up-Form

Pediatric Intake Forms
Child Consent - Form Child Consent
Child Intake - Form Child Intake
ASD Child Intake - Form ASD Form 2
Functional Medicine Info Working With the Doctor
Medical Symptoms Questionnaire MSQ Form
Privacy_Form Privacy-Form

Questions? Please Call Us
Office Telephone Number (717)-243-0616

Please bear with us as this web page is still under construction.

Questions or comments? Please call 717-243-0616.