This form is designed for patients whom have more in-depth topics to discuss with Dr. Nicole. It should be completed with the Comprehensive Patient Intake Form. It is meant to provide Dr. Nicole with further information about your current health. (Examples: Diabetes, Hashimoto’s Disease, Parkinson’s Disease, PTSD)
If you have one or two musculoskeletal complaints (Examples: Low Back Pain, Neck Pain, Tennis Elbow, Carpal Tunnel), please only complete the Basic Patient Intake Form and notify the front desk staff to ensure your scheduled appointment is correct for your healthcare needs.