Pediatric Intake Form (0 – 1 year)
Pediatric Intake Form (0-1 year)word
Pediatric Intake Form (2 – 16 years)pdf
Pediatric Intake Form (2 – 16 years)word
Dear Parent,
I am dedicated to helping your child become as vital, healthy and happy as possible and to achieve their health goals. Because of my commitment to you, our clinic is different to many other Natural Health Clinics.
All New Patients start with an Initial 2 hour appointment. After your initial appointment I will take all the information we have discussed, plus your online intake form, and I spend time researching exactly what is out of balance in your child’s body.
I will need to gather more information from tests to clarify certain biochemical pathway imbalances and to get baseline markers to enable us to monitor your child’s progress. I will inform you of which tests are most useful following your initial appointment.
The tests I require will depend on the information you give me during the initial screening. In many cases they can be conducted in the privacy of your own home if urine, saliva or stool tests are required, or in a pathology collection centre if a blood sample is required. These tests give me a great deal of information about your child’s body and how they are reacting to their diet and lifestyle.
Once I have the information from your child’s tests I will finalise my research and present you with a Naturopathic Program. This is always an insightful and fascinating report all about your child and their wellness. Your Program will explain to you what is happening in your child’s body, why they are feeling or acting the way they are and I will provide for you a simple and effective solution for you to correct what has gone wrong.
I am confident your child will be feeling much better in a short while.
Warm Regards,
Gabi Giacomin
