CHH Intake Form
Sign in to Google to save your progress. Learn more
Informed Disclosure
We are not doctors.

We are herbalists and educators.

Herbally, we work in a holistic paradigm which takes into account individual variation and personalized intervention. Nutritionally, we work with the principles of traditional & ancestral nutrition, as well as individual variation. In all cases, our primary goal is to help you nourish and support your body so that it can heal itself.


Herbalism can integrate with conventional medical strategies as part of your whole health plan. We are happy to provide you with information and research in writing that you can discuss with your other healthcare providers at any time. You should notify your medical practitioners of any herbs or supplements you are taking. It is your responsibility to notify us of any prescription medications you are taking so that we can suggest safe herbs for you.


Herbs work over time; however, if at any time you don’t feel happy with any recommendations, or if you feel you might be having an adverse reaction, please let us know and we will work to find something that you are comfortable with.

Finding a path to good health is your own personal right and responsibility: the final decision on any recommendation – whether to follow it or not – is always yours.


The nature of this appointment is educational: it is important to us that you have a good understanding of what we discuss, no matter how many questions you need to ask. So don't hesitate!



Please enter your name and the date, to indicate you have read and understood this information:
Name *
Today's Date *
MM
/
DD
/
YYYY
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy