Filling Out Forms

Once you have scheduled your Primary Wellness Consultation at Optimum Health, you will be given the password needed to download the all five of the “Primary Wellness Consultation Forms” listed below.  You may download them here, fill them out and bring them with you to your appointment.  Or, if you prefer, you may arrive 15 minutes early for your appointment and fill out the forms at our center.

Primary Wellness Consultation Forms

There are five forms that must be filled out and presented at your initial consultation  appointment.  These forms are the:

  • Health Profile & Treatment Form
  • Medicine & Supplement/Vitamin Form
  • Private Records Form
  • Picture Use Form
  • Client Information Sheet

To download all five forms at once, click the download link below.  Before printing the forms, please set all margins (top, bottom and sides) to half an inch.  Otherwise, the forms will not print correctly.


If you would like to schedule an appointment, call our center.
We will be happy to assist you.

HEALTH ISSUES? 804-677-6061


Miscellaneous Forms


Optimum Health’s Concept of Healing

Primary Wellness Consultations

Total Body Cleanses/Detoxes

Natural Healthcare Center Location

Donate to Our Center for Clients Needing Help

Let our highly trained professonals guide you through this process. Call 804-677-6061Schedule your appointment to get started on your path to Optimum Health. Member: Certified Natural Health Professionals





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  • We Want to Be Your Natural Healthcare Center


    Optimum Health, Natural Healthcare Center is your primary care for natural healthcare. We have certified staff members who are committed to assisting clients nationwide in attaining their optimum health status naturally. We give you the personal touch as we become a part of your team that helps you strive for optimum health. Become a part of our family and heal utilizing traditional, homeopathic, alternative, complimentary and natural methods with health kinesiology, quality supplements and the elimination of toxins with total body cleanses.