Online Patient Forms

Holze Wellness Center offers our patient forms online so you can complete it in the convenience of your own home or office.

  1. If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download it for free.
  2. Click on the necessary form, print it out and fill in the required information.
  3. Fax us your printed and completed forms or bring them with you to your appointment and save time on your visit!

adobereader

Download the Free AdobeReader®

New Patient Health History Forms

Required

This educates us about the history and current state of your health. What questions, concerns, or goals can we help you with regarding your wellness? Let us know!

pdf Patient-Questionnaire

pdf Comprehensive Wellness Questionnaire