New Patient Remote Paperwork and Forms

Hi!  We are all so excited to be able to get you the help you need!

 

Please fill out the below forms TODAY.  Failure to do so may result in rescheduling your appointment.

 

Also, please click “Save and Close” after completing each form or else we will not receive your form, which may results in rescheduling your appointment.
  1. The first step is to set up your patient portal.
    1. Click on the following link: https://www.optimantra.com/optimus/om/patient/login
    2. Select “New Sign Up” or “Set Password”
    3. Follow up the prompts and fill out the necessary information.
  2. Please click on each of the below links and fill out each form.  Once you complete filling out the form you must click Save and Close or else we will not receive your form, your appointment will probably be delayed and you’ll have to fill out the forms again.
    1. Link for Requisition Form
    2. Link for Hair Instruction Form
    3. Link for Welcome Pack And History
    4. Link for Alternacare Symptom Survey Form (Updated)
    5. Link for FEES FORM (10/1/22)
    6. Link for Notification And Explanation
    7. Link for HIPAA Compliance Patient
    8. Link for Health Summary
    9. Link for Patient Clinic Agreement
    10. Link for Permission state waiver

Thank you,

Dr. Rob and Team

Take our Free Root Cause Health Evaluation today!

If you have a question, or would simply like more information, please fill out the form below:

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