Health Forms

24-Hour Cancellation Notice

We understand that unplanned issues can come up and you may need to cancel an appointment. If that happens, we respectfully ask for scheduled appointments to be cancelled at least 24 hours in advance.

Our specialists want to be available for your needs and the needs of all our clients. When a client does not show up for a scheduled appointment, another client loses an opportunity to be seen. Although we have always had a cancellation policy, circumstances have caused us to enforce a policy of charging for no-show appointments and those appointments not cancelled within 24 hours.

If we do not receive 24-hour notice to cancel or reschedule your appointment, you will be charged the full appointment cost.

Successful Aging Health Questionnaire

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Pediatric Health History

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Health Profile Questionnaire

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Health History

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Cancellation Policy and Disclaimer

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The programs and services offered by Chesapeake Holistic Health are not substitutes for medical advice or treatment prescribed by your physician. You are urged to seek the advice of a physician before beginning any nutrition or supplementation program or protocol. Our programs, services, and information should not be construed as medical advice, and Chesapeake Holistic Health disclaims any liability from and in connection with this information. As with any exercise or nutritional program, if at any point during the program you begin to have any physical discomfort, you should stop immediately and consult a licensed health practitioner. Individual results may vary, and past performance is not an accurate predictor of future results. No statements or claims made by employees or representatives of Chesapeake Holistic Health have been evaluated by the United States Food and Drug Administration.