Apple-A-Day provides these forms online so they can be completed in the convenience of your own home or office. Dr. Tips reviews them before your phone or in-person consultation. Also below are some support instructions should you lose your printed copy.
- Download the necessary form(s), print it out and fill in the required information.
- Fax us your printed and completed form(s) to 512.330.0704.
- If you don't already have AdobeReader® on your computer, Click Here to download a free version from the Adobe website.
New Consultation Health History Form
This lets us know more about your history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with?
Member Wellness Agreement/Overview Form
This form specifies that we use and sell nutritional/herbal supplements for whole body nutritional health; and that we do not diagnose or treat any disease whatsoever. It also secures your appointment with your pledge of payment.
OPTIONAL -- IF REQUESTED ...
Constitutional Chinese 5 Element Questionnaire
This optional form examines underlying "constitutional" imbalances that may predispose a person toward certain metabolic dysfunctions. It's fine to fill out and include this form in your introductory materials. Otherwise, Dr. Tips will request completion of this form IF he finds that it will provide key insights or a point of leverage regarding your case.
RESOURCES -- SHOULD YOU NEED ...
How to Take A Homeopathic Remedy (X, C, & M Potencies)
This resource is a copy of the instruction sheet sent with "single, dry dose" and "liquid multi-dose" homeopathic remedies. It explains how to take a homeopathic remedy.
How to Take An "LM" Homeopathic Remedy (LM, Q, 0/1 Potencies)
This resource is a copy of the personalized instruction sheet sent with any LM potency homeopathic remedy. It explains how to take an "LM" remedy (also designated as "Q" for quintessimal" or written as a fraction such as Q/1, or O/1.