Hours of Operation:
Mondays: Closed
Tuesdays – Thursdays 9:00 to 5:00pm

 

Address: 10722 Carmel Commons Blvd,
Suite 450, Charlotte NC 28226,

Phone: 704-543-5540

New Patient Forms:
If you need to print and fill out forms then click below:

1) Adult Patient Form (13 years old and up) or Child Patient Form (12 and under)
2) Body System Analysis
3) Emotional Health Sheet
4) Cancer Support Disclaimer

Directions to fill out the Required Documentation:

When you fill out the Systems Survey Form please remember to mark only the symptoms you experience as:
– 1 if the symptom is Mild (rarely occurs)
– 2 if the symptom is Moderate (occurs several times per month)
– 3 if the symptom is Severe (occurs almost constantly)
– if the symptom does not apply please leave it blank

– at the end of the document please list your top 5 complaints in order of importance

Similarly, as you fill out the Emotional Balance Questionnaire number each statement from 1 to 3 (least to strongest) that portray and match the emotions and moods you are presently experiencing. If a statement does not match a mood you are experiencing just leave it blank.