Health Forms

All patients must fill out the Client Orientation Form (before first appointment only).

Cancellation Policy

We respectfully ask clients to cancel scheduled appointments at least 24 business-hours in advance. If you do not cancel within the 24 hour time-frame, you will be charged the full appointment fee.

For first-time appointments, we require at least 48 business-hours notice for an appointment cancellation. If you do not cancel within the 48-hour time-frame, you will lose the deposit amount.

Health Forms

Please click on each practitioner’s name to access and download their forms. Please do not fill out the forms until after download, as information entered in your web browser will be lost when you go to download or print.

Jennifer Salos, MS, CNC

Send completed form by email to Jennifer or fax to 410-757-6742 – before your appointment.

Health History (before first appointment only)

Health Profile Questionnaire (before each appointment)

Pediatric Health History (before first appointment only – 12 years and under)

Saliva Evaluation Form (before each saliva appointment)

Pet Evaluation Form (before each pet appointment)

Supplements Tracking Form (before each appointment)

Cathy Logan, CHC, COT, CECP

Send completed form by email to Cathy or fax to 410-757-6742 – before your appointment.

Foot Detox Service Waiver (before first appointment only)

Emotions Code Sessions Waiver (before first appointment only)

Katherine A. Sale, MSW, MAc, LAc, CNC

Send completed form by email to Katherine or fax to 410-757-6742 – before your appointment.

BioClear New Client Packet (before first appointment only)

Health Survey (before each appointment)

Foot Detox Service Waiver (before first appointment only)

Jennie Donnelly, Certified Integrative Health Coach, COT

Send completed form by email to Jennie or fax to 410-757-6742 – before your appointment.

Health Coach Form

Goals Form

Foot Detox Service Waiver (before first appointment only)

Cassandra Bellarei, INHC, CHHC Integrative Health Coach, Reiki Master Practitioner

Intake Form (submitted electronically)