Patient Forms

First Visit

Click here to download your new patient intake form.

Your first visit will entail the following:

  • Consultation* to review your health concerns and health interests.
  • Physical exam that will assess neuromuscular skeletal needs related to establishing the proper tone of your nervous system. Includes range of motion studies, muscle strength analysis, aberrant muscle tone discernment, ph studies.
  • First and subsequent visits will assess and address nervous system disturbances related to structural needs, electromagnetic pollution, nutritional deficiencies, allergy sensitivities, toxicity levels and emotional stress.

Chiropractic, Nutrition & Wellness Patient Intake Forms

Download. Print. Complete.

Please print and complete your Chiropractic and Nutrition patient-forms before you come into the office.

  • Patient Symptom Survey
  • Nutrition Patient Questionnaire (please call the office for the current form)
  • Daily Food Intake Log (please call the office for the current form)
Science Based Nutrition blood test wellness report

Customized Evaluation

Bring in your blood test results for a wellness evaluation and 2nd opinion!

Learn More

Check out Dr. Ventola’s Stress Mastering Course, Master Stress with HeartMath, and his book Healing Verses.

Make an Appointment

Call 404-316-7081 or send us a message and we will get you scheduled.
1756 Century Boulevard, Suite B, Atlanta, GA 30345

Contact Us