Thank you for your interest in our care.

For questions you may schedule a mini phone consultation (15 minutes) to discuss your case at no charge.
Call 828-682-6157 or 828-778-6157 or email lesiacruz@yahoo.com
This call is designed to help us understand your health concerns and goals. We can then determine if we can accept your case, we only accept cases we feel confident we can help.

Print New Patient Forms and fill them out before your first appointment and save 20 minutes at your appointment.

 

New Patient Forms for Chiropractic and Laser Therapy:

Patient History Form

Consent to care

Illness-Wellness Continuum

Please read the HIPPA Privacy notice by clicking here and bring the form below with you to your appointment.

Acknowlegement of Receipt of HIPPA Privacy Notice

 

Health Coaching

Health Coaching Intake Form

Patient History Form
 

Functional Medicine:

Metabolic Assessment Form

Brain Function Assessment Form

Brain Health Nutrition & Assessment Form
 

Children:

New Patient Intake Form – Child

Consent to Treat a Minor
 

Spanish / Español:

Nuevo Paciente Formulario

 

New Patient Forms for Cranial Facial Release:

Cruz Life Center Health History Intake Form

Informed Consent Form for Cranial Facial Release
 

Spanish / Español:

Cranial Facial Financial Policy

 

PLEASE REVIEW THIS INFORMATION CAREFULLY.  IT DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU MAY GAIN ACCESS TO THAT INFORMATION.

HIPAA Acknowledgement Form

HIPAA Privacy Notice

HIPPA Privacy Notice condensed