Appointments & Medical history
Patient Portal
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New Patient Intake Forms (ages 16+)
Please fill out this confidential health history form as completely as you can. The more information you provide us, the better we will be able to help you.
NEW PATIENT INTAKE FORM
METABOLIC ASSESSMENT FORM
Naturopathic Intake Forms
Please fill out this form if you are scheduled for a visit with our naturopathic doctors and bring it with you to your first appointment.
NEW PATIENT INTAKE FORM
NUTRITIONAL ASSESSMENT FORM
METABOLIC ASSESSMENT FORM
Pediatric Intake Forms (newborns – 15 years)
Please fill out this confidential heath history form if the patient in question is a newborn or under 15 years of age and bring it with you for your first appointment.
NEW PATIENT INTAKE FORM
Acupuncture Intake Forms
Please fill out this form if you are scheduled for an acupuncture session and bring them with you to your first appointment.
NEW PATIENT INTAKE FORM
Esthetics Intake Forms
Please fill out this form if you are scheduled for an esthetics session and bring it with you to your first appointment.
NEW PATIENT INTAKE FORM
Contact Our Office
Address
Cohn Health Institute
3151 Airway Avenue, Suite U-3
Costa Mesa, CA 92626
Hours
Monday 8:00 am – 6:30 pm
Tuesday 9:00 am – 5;00 pm
Wednesday 8:00 am – 6:30 pm
Thursday 9:00 am – 6:30 pm
Friday 8:00 am – 3:00 pm
Saturday 9:00 am – 3:00 pm
Sunday Closed