Welcome to the Client Forms

Some forms are fillable PDF and can be saved and just attached and few are scanned and uploaded via email. If you respond by attaching the documents to the email thread where I sent the forms, it will remain encrypted with the original password.

Clinical

Becoming My Patient

Becoming My Patient

Client Service Agreement

Client Service Agreement

Please read and sign the consent form signature page and return it to me at drleslie@protonmail.com

Client Intake Form

Client Intake Form

Please fill out the Intake form. If anything is irrelevant or which you cannot or choose not to answer just skip it. Please return it to me at least 48 hours prior to our first appt.

Laboratory Instructions

Hair Sample Collection

Hair Sample Collection

CAREER COACHING/COUNSELING

Please fill out all 3 forms and return to me via email drleslie@protonmail.com

Becoming My Client

Becoming My Client

Client Service Agreement

Client Service Agreement

Please read and sign the consent form signature page and return it to me at drleslie@protonmail.com

Client information Form

Client information Form