We realize our gender-specific health history forms may not be appropriate for all clients. We apologize if this is true in your case. Please complete the form you feel best describes your situation. I am in the process of developing gender-neutral forms. Thank you for your patience with this.
FEmale Intake form➣
Male intake form➣
Download the form to your computer as a PDF. Fill it out. After completing, please email it to Deep Well Health at least one week before your scheduled appointment. You may, instead, fax it to me at 1-413-931-3200. It may be necessary to reschedule appointments if your history arrives too late to be considered thoroughly. Thank you.
You are almost done! Next step, schedule an appointment using the link below. We look forward to speaking with you soon.