Intake Forms
For your convenience, please print and fill out the following forms prior to our first appointment:
Information and History | PDF | intakeformmarch2010.pdf
Patient Information Consent | PDF | infoconsentmarch2010.pdf
Consent to Treament | PDF | treatmentconsentmarch2010.pdf
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Mona Searles, RN, ANP, LAc, MPH | Searles Wellness:
2700 SE 26th Avenue, Suite D, Portland, OR 97202 | 503-943-9842