Patient Forms

Baritz Wellness Center offers our patient forms 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, please visit their site to download it or use a compatible browser, such as Google Chrome.

Then, download the necessary form(s), print it out and fill in the required information. You can either fax us your printed and completed form(s) or bring it with you to your appointment.

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

>> Download & Print Form

This form is filled out by all patients applying for nutritional services or for a complimentary nutritional screening. For your convince, you can print it out and bring it with you on your first visit. The instructions are on the top of the form and will provide vital information we will use to asses your nutritional health.

>> Download & Print Form

This form is filled out by persons who are interesting in receiving nutritional consultations by phone.

>> Download & Print Form