Thank you for downloading the Patient Intake Form!

Thank you so much for supporting National Public Television and for signing up to download the Patient Intake Form.

Download your Patient Intake Form here.

You’ve just taken the first step towards reclaiming your whole health and living the vital life you know you deserve to live.

If you’re a Health Care Provider add it to your intake paperwork whenever you see a new patient/ client. If you’re a Health Care Patient,  ask the people responsible for your health care to sign it. Let’s reclaim the heart of medicine where it really matters – from the inside out.

With love & healing,

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