Health History Forms

You MUST save the Health History Form to your computer before filling it out.
After saving the form, complete the entire form and save it again to your computer.
Then email the completed form to our office.

Wellness Health History Form Filling out this form using Acrobat Reader within Windows Internet Explorer may not work. Please use Acrobat Reader "stand alone". Using Google Chrome works fine.

 

Center for Holistic Care, PLLC
21316 Davidson Street
Cornelius, NC 28031
704 895-6788

Your First Visit

We want your first visit to be both pleasant and beneficial to you.

What to Expect Your First Visit

21316 Davidson Street
Cornelius, NC 28031
704.895.6788

Office Hours

M 1 pm to 6 pm
T 1 pm to 6 pm
W 1 pm to 6 pm
Th 1 pm to 6 pm
F 1 pm to 6 pm