New Patient Forms

Life Wellness Center is happy to provide both Eagan and Lakeville with the best customer service in town. In order to make sure that your appointment goes as scheduled, make sure to have your paperwork filled out and ready beforehand. Find the paperwork associated with the reason for your visit below. If you have any questions regarding the forms, feel free to contact our office and we will do our best to assist you.

If you are a new or existing patient, please download and complete the appropriate form(s) below.

Please bring the completed form(s) to your scheduled appointment:

New Patient Health Information Form

Updated History Form

Motor Vehicle Collision Form

Personal Injury Verification Form

Insurance Questionnaire/Benefits Verification Form

Worker’s Compensation Verification Form

Worker’s Compensation Questionnaire Form

Patient Responsibility Form

Credit Card Authorization Form

 

Massage Therapy Clients:

New Massage Therapy Intake

 

Ideal Protein Clients:

Ideal Protein Health Profile