+1 3048 REMEDY Rakhi@RemedyTx.org


It is extremely helpful to have you prepare some information before your first appointment. This ensures that our visit is as thorough and useful as possible. These forms include a questionnaire, diet diary, disclosures and consent forms. Please complete all four pages of the questionnaire, especially the history. You can fill out the diet diary for any 3 days in a row between now and your appointment. 

Thank you for putting your time into this preparation and please remember to take print and bring them with you to your appointment. 

For All Individuals: Disclosure Statement and Consent for Treatment

For Adults: Individual ‘ADULT’ – History And Physical Form

For Minors: Individual ‘MINOR’ – History And Physical Form