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 Pathways Medical and Holistic Centers

Intake Forms

Initial Appointments – Dr. Hicks

Adult Intake Form

Child Intake Form

 

Private Contract for Medicare Patients

Initial Appointments – Nutritional Balancing
Balancing Intake Form

 

 

For those needing a copy of their medical records from Dr. Hicks, please fill out this form:

Medical Records Authorization Form

 

 

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Note: Adobe forms could take a few minutes to download and may appear as if nothing is happening, please be patient with this process. Newer versions of Internet Explorer provide pop up blocking and depending on the settings can also prevent a smooth download.