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Cameron Wellness Center and Spa
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Intake Forms & Handouts

You are here: Home1 / Intake Forms & Handouts

Intake Forms & Handouts

Please print and fill out the appropriate intake forms below prior to your first appointment, or arrive 20 minutes early so you’ll have time to fill out the forms in the office.

Wellness Center

Naturopathic Medicine Forms

Naturopathy

Adult New Patient Intake Form

Patient Agreement Form

Privacy Act Form

Pediatric New Patient Intake Form

Patient Agreement Form

Privacy Act Form

IV Therapy Forms

IV Therapy

Intake Form

Consent Form

B12 Injection Forms

B12 Injection

B12 Intake Form

Patient Handouts

Low-Dose Naltrexone (LDN)

Nebulizer Tea Instructions

Ozone

Prolo Post Treatment Instructions

Thyroid Tracker

URI (Upper Respiratory Infection) Protocol

Life Spa

Esthetics Forms

Esthetics

Health History

Acne Consent

LED Consent

Microneedle Consent

Microderm Consent

Massage Therapy Forms

Massage Therapy

Health History

Massage Consent

Acupuncture Forms

Acupuncture

Health History

Acupuncture Consent

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Let’s Get Started!

Call Today (801) 486-4226

Address
1945 S 1100 E
Ste. 100
Salt Lake City, UT 84106

The Cameron Wellness Center is conveniently located in the Sugar House area of Salt Lake City and is adjacent to the Sugar House Post Office. Patient parking is available in the rear of the building and is accessible via Ramona Avenue

Google Map

Business Hours
Monday-Saturday: 9:00 AM to 5:00 PM
​Sunday: Closed

Contact us by email

Location and Contact

1945 S 1100 E Ste 100
Salt Lake City, UT 84106
P: (801) 486-4226
F: (801) 487-6856
M-F: 10a-5p
Sa: 10a-4p
Su: Closed

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