Online Forms


Online Forms

Innovative Medical Centers offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader┬« installed on your computer, Click Here to download
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment

New Functional Medicine Patient Form:

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

New Client History and Lifestyle Intake Form


Food Sensitivity Test Questionnaire:

Food Sensitivity Testing Intake Form

Inflammation Questionnaire:

Inflammation Questionnaire

New Regenerative Medicine Patients:

New Regenerative Medicine Patient Intake Form


Innovative Medical Centers
55 Caren Avenue , Suite 360
Worthington, OH 43085
Phone: 614-254-5572
Office Hours

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