2046 Murray Holladay Road, Suite 204, Holladay, Utah  84117
(801) 272-1246

Natural Solutions for Healthy Living

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New Patient Paperwork

Utah Patients

  1. Please print the documents below.  If you have trouble viewing or printing the documents, call us at 801-272-1246.

  2. Fill out all patient information.

  3. Bring all completed forms with you to your first scheduled clinic appointment.  This will save you substantial time on the day of your appointment.

Out-of-state Patients

  1. Please print the documents below.  If you have trouble viewing or printing the documents, call us at 801-272-1246.

  2. Fill out all patient information.

  3. Keep the Privacy Policy and Online Communications policy statements for your records, and mail the completed forms to:

Utah Weight Loss & Natural Hormone Clinic
2046 Murray Holladay Road, Suite 204
Holladay, UT 84117-5125

Click the links below to download the forms:

Female patient (PDF, 272K)

Male patient (PDF, 252K)