Forms

Forms

This page contains all the forms you need to complete prior to your first visit with Dr. Galina. Please take the time to carefully fill them out.

Please download and print this document which lists everything you need to know before your first visit with Dr. Galina Mironova.  Careful review of this form will ensure that the appointment runs smoothly and on-time.

New Patient Checklist

Complete and submit this secure online questionnaire prior to your first appointment with Dr. Galina.  It takes about 30 minutes to complete.

New Patient Intake Form

Please print and complete the following three forms and bring them to your first visit.

Review of Systems

Consent for Naturopathic Treatment

Financial Responsibility

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