Appointments &  Medical history

Patient Portal

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. 

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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.

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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.

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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.

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Contact Our Office

Address

Cohn Health Institute
3151 Airway Avenue, Suite U-3
Costa Mesa, CA 92626

Hours

Monday 9:00 am – 6:30 pm
Tuesday 9:00 am – 2:30 pm
Wednesday 9:00 am – 6:30 pm
Thursday 9:00 am – 6:30 pm
Friday 8:30 am – 3:00 pm
Saturday 9:00 am – 2:00 pm
Sunday Closed 

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