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Homeopathy is effective | Empowering Better Health | Columbus Ohio | Ohio | Homeopathy | Deb Holcomb

History & Intake Form

For new clients, this form should be filled out and brought with you at the time of your appointment. Please fill out the information to the best of your knowledge and recollection.


Additionally, please bring all supplement bottles, a list of any prescribed and/or over the counter medications, and a copy of any recent labs.  This will help us use this time more efficiently.


Click here to download this form



General Questions

This questionnaire is specifically designed to enable appropriate and effective homeopathic treatment. 

While some of the questions may seem irrelevant to your immediate health concerns,  they are important to determine your overall health picture. 


Please answer the questions in as much detail as possible and bring the completed form with you to your initial appointment.  If you find any of the questions difficult to answer, please feel free to skip those.


Click here to download this form


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