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Online Forms

The Wellness Spot offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

Please print the following forms to fill out and bring in to your first visit at The Wellness Spot:

New ADULT Patient Forms - Required

This lets us know the history and current state of your health; what questions, concerns, goals, regarding wellness we can help you with: Download & Print Health History Form

This document helps you communicate what hurts, where and how:  Download & Print Symptom Locator Form

This document shares basic contact, disclaimer and agreement information:  Download & Print Registration Form 

Your signature on the bottom of the Registration form (above) confirms you have read and understand the below documents:

Download & Print Consent to Treat Form

Download & Print  HIPPA Notice of Privacy Practices Form




New PEDIATRIC Patient Forms - Required

This lets us know the history and current state of your child's health; what questions, concerns, goals, regarding wellness we can help your child with: Download & Print Pediatric Health History Form

This document helps your child communicate what hurts, where and how:  Download & Print Symptom Locator

This document shares basic contact, disclaimer and agreement information: Download & Print Pediatric Registration Form

Your signature on the bottom of the Registration form (above) confirms you have read and understand the below documents - (please print and sign the Consent to Treat a Minor Form):

Download & Print Consent to Treat a Minor

Download & Print HIPPA Notice of Privacy Practices Form



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