For those coming to our office for more chronic or complex conditions, you may want to take the extra time to fill out this FUNCTIONAL MEDICINE ASSESSMENT FORM.  **PLEASE NOTE** This form is already included in the "Functional Medicine New Patient Packet".  Please print this pdf form and fill it out prior to coming for your appointment. 

Along with this form, please gather all pertinent lab and imaging reports from the last 2 years.  You may wish to bring labs from further back if they are speciality labs (heavy metals, food allergies, hormones, stool testing, etc...)  This allows us to use a Functional Medicine systems approach to better evaluate what might be causing your symptoms.  This form is more in depth than most any other questionnaire you have ever filled out for a health care practitioner.  That is because we are digging deeper into your symptoms to find the subtle problems and the cross-talk between your organs and glands.  This complex communication drives our analysis of your condition and helps us find problems that may have gone undetected in other health care settings.  We look forward to partnering with you on this journey toward renewed health and vitality. 


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Where to find us?

Idaho Center for Integrative Medicine
3224 N. Maple Grove Rd.  Boise, ID 83704

tel. (208) 629-5374

fax. (208) 629-5394