Intake Forms & Handouts

To schedule your Naturopathic Medical Appointment, call the Cameron Wellness Center at 801-486-4226. Please print and fill out the 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. Policies and intake forms are listed below:

Wellness Center

• All Patients

  • Patient Agreement Form

  • Privacy Act Form

  • New Patient Contact Information Form

• Adults

  • Adult New Patient Intake Form

• Children 

  • Pediatric New Patient Intake Form

• B12 Injection

  • B12 Intake Form

IV Therapy

• IV Patients

  • IV or B12 New Patient Intake Form

  • Intake Form Consent Form 

Spa & Beauty

• Esthetics
  • Health History
  • Acne Consent
  • LED Consent
  • Microneedle Consent
  • Microderm Consent 
• Massage Therapy
  • Health History
  • Massage Consent
• Acupuncture
  • Health History
  • Acupuncture Consent 

Handouts