Evaluation Forms for Initial Functional Appointment







The Medical Symptom Questionnaire


Male Intake Questionnaire

Female Intake Questionnaire



Financial responsibility




Telemedicine Consent




Notice of Privacy Practices


Cancellation Policy



Frequently Asked Questions



Functional Integrative Program



Working with a functional medicine physician





























995 Old Eagle School Rd, Suite 311, Wayne, PA, 19087


This website is for informational purposes only and is not a substitute for medical advice, diagnosis or treatment.

Information provided on this website is a property of Functional Holistic Healing LLC.


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