New Patient Forms

HIPPA Privacy (Required)

Health History (Required)

History Timeline (Required)

Weekly Food Log

Metabolic Assessment

Please download, print and fill out the new patient forms before your first appointment. The first three forms are necessary. If you have a chronic condition please fill out the remaining two forms. If a question does not apply to you then simply leave it blank. Your details are very important to Dr. Allexi, so please fill out your forms as completely as possible. Thank you!

If you are unable to bring these completed forms to your first appointment then please arrive at least twenty minutes early to complete your forms.

If you have a recent lab or test result please bring copies. If you have a report for an X-ray, CT Scan, MRI or other study, please bring a copy with you. If you cannot make copies please bring your originals and we will make copies.

Of course, there are no guarantees in healthcare, but your health and welfare is Dr. Allexi’s utmost concern. At any time, please let Dr. Allexi know if you have any questions or concerns regarding your care or treatment and she will be happy to address them with you. Dr. Allexi wants the best for you!