The following documents are intended to build a mutually beneficial client/clinician relationship upon your office visits. Please review, print (if possible), and complete these forms prior to your visit with us. We also have copies in the office. Thank you!

 
 

This document provides new clients with an overview of Nutrition Response Testing. It will help you understand NRT as an analysis of your body's reflexes to help us determine the exact nutrients you need to supplement your diet, in order to bring about balance and better health. 


This client waiver is used to authorize Luisa Szakacs to perform a Nutrition Response Testing health analysis and to develop a natural, complementary health improvement program for clients, which may include dietary guidelines, nutritional supplements, etc. in order to assist in improving health, and not for the treatment, or "cure" of any disease. 


By completing a symptom survey, our team will better understand your current state of health and potential health needs. We encourage you to be honest upon completing, and we will discuss the symptoms listed and possible causes along the way of your treatment.


All new clients are asked to submit this form in order to provide an initial snapshot of your personal contact information, daily habits and overall health status.


The Toxicity and Lifestyle Evaluation Questionnaires are designed to aid our team in assessing a client’s potential for the purification detox program. The completion of this questionnaire will provide an understanding of the degree of toxic elements that may be present in a client’s body due to the use of chemicals, pesticides, cleaning products, etc.


During your visits, we may ask you to keep a daily record of your food and drink intake. This will help us evaluate your diet more accurately and determine the effects it could have on your health. These forms are available in our office or can be downloaded here for printing.