New Patient Intake Forms
Prior to your first visit with me, please download and print, then complete, the appropriate New Patient Intake form and a copy of the Informed Consent form. Feel free to mail, email, fax or drop a copy off to the clinic prior to your appointment with me, or simply bring it with you to your visit.
I also encourage you to bring along any additional health history information you might have including past or current laboratory test results (ie. Blood work, X-ray/ CT/ Ultrasound/ MRI reports).
I look forward to meeting with you!
I also encourage you to bring along any additional health history information you might have including past or current laboratory test results (ie. Blood work, X-ray/ CT/ Ultrasound/ MRI reports).
I look forward to meeting with you!
| New Patient Intake form - Age 13 to Adult |
| New Patient Intake form - Birth to 12 years |
| Informed Consent - Must be signed by ALL patients |
Naturopathic Medicine in Regina, Saskatchewan
Dr. Julie Zepp Rutledge N.D.
Prairie Sky Integrative Health
2146 Robinson Street ~ Regina, Saskatchewan ~ S4T 2P7
p. (306) 757-HEAL [4325]
f. (306) 522-0745
Prairie Sky Integrative Health
2146 Robinson Street ~ Regina, Saskatchewan ~ S4T 2P7
p. (306) 757-HEAL [4325]
f. (306) 522-0745