Portland Chiropractor | Chiropractic, Nutrition, Fascial Manipulation, and Trigger Point Dry Needling

Optimum Function = Optimum Health

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Nutritional Therapy Forms

Click below to download the necessary forms. Please be sure that you fill out these forms in their entirety. If you have any questions email forms@OptFunction.com.

Initial Patient Forms

• Initial Patient Handout
• Initial Patient Intake
• Detoxification Questionnaire
• Nutritional Assessment Questionnaire
• Diet Diary

Privacy Policy (Please feel free to print this up for your own records, this does not need to be filled out)

Please bring the filled-out forms to your first appointment. If you want to, you can fax them to me at 503-716-4575 or scan them and email them to forms@OptFunction.com.