Health Forms

Prior to your initial visit, please complete send us the following via email, snail mail or fax –

  • A completed health form (see below)
  • A completed consent form (see below)

Please bring electronic or paper copies to your first visit of the following (you may also upload these via your patient portal which you will obtain we schedule you for your initial appointment) –  

  • All lab results, imaging reports and/or pathology reports (not actual images, only reports) from the past 2 years
  • A timeline of your health history
  • A list of all current medications
  • A list of all current supplements (with FULL label photos)
  • (optional) Please use this LINK to create a spreadsheet of your labwork if desired
The health and consent forms are necessary to schedule your initial visit. 
The other items will greatly help the practitioners to evaluate your unique health situation and needs. 
We strive to individualize each patient’s care and over the years we have found that this information is necessary for most of our patients assessment.


Fax: 202-833-5755

Mail it to us at: GW Center For Integrative Medicine – 908 New Hampshire Ave Suite 200 Washington, DC 20037

We will call you within 48 hours after our Medical Director has reviewed the forms to set up the first evaluation appointment. Please contact us if you do not hear from us to make sure that your form has been received.

We look forward to meeting you.


[Note: The forms are viewed and printed using Adobe Acrobat Reader, included with most computers. If you do not have a copy, go to for a quick, easy and free download.]


Cancellation Policy

When you need to cancel an appointment, we would appreciate your consideration for our providers’ time that has been set aside for you, and for the time to review your medical history that you sent us.

If you cancel less than two business days prior to the initial appointment (48 hours, Saturday for a Monday appointment), there will be a charge equal to 100% of the provider’s fee.

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