New Patient Intake:

These Intake Forms Are Essential To Your Care Plan

In order for Dr. Myatt to have as much information as possible with which to research your case and plan your care, we have a packet of information forms that all new patients must complete:

These Forms Are:

Patient information This form explains your relationship with Dr. Myatt, and how you will work together towards your best health ever.

Authorization to Release Medical RecordsThis form, signed and given to your other health care providers will allow them to send your medical records to Dr. Myatt for her study and analysis.

Patient RegistrationThis form sounds simple, but here you will provide a great deal of information about yourself, your health, and what you wish to achieve as you work together with Dr. Myatt.

Comprehensive Health AppraisalThis detailed health questionnaire and symptom survey will make you think hard. By completing it fully and honestly, you will provide Dr. Myatt with valuable insights to your body systems and clues to help her in her investigations as she develops your personalized Health Action Plan.

We suggest that you open these pages by clicking on the links above, and then print them out. You may then complete them and then fax or mail them back to us or scan them and email them. If you fax or email your forms to save time, please also mail us the originals!

Our Fax: 1-(928)-536-5691

Our Mail:
Dr. Myatt’s Wellness Club
P.O. Box 900
Arizona 85937