Michael Uzick, N.M.D.

Naturopathic Physician

 
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After making your appointment, please print and fill out the intake form below.  Bring it with you to your visit. 

Do it now and there's no need to show up early at the clinic to fill out forms.

 

Click on the link to open in browser.  Then print.

OR

Right click on link, select "Save Target As" then save file to your desktop.  Double click on the file to open it and print.

 

Patient Intake Form Word Document

Patient Intake Form Adobe PDF file

 

If you have had recent lab work, please bring copies to your visit.

Cancer patients should bring pathology reports (from biopsy and surgeries, imaging reports (CT scans, MRI, PET scans etc.). You don't need to bring the actual films, just the radiologist's written reports. As well as recent blood work.

If you are taking nutritional or herbal supplements, please bring them all to your visit. Even if you need a suitcase to hold them all.

 

New Patient Intake Form

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Send an E-mail to: Doctor Uzick

 

Michael Uzick, NMD, FABNO           

3920 North Campbell Avenue

Tucson, Arizona 85719

520-495-4400