Synergistiq Wellness

Clearwater

(727) 754-2936

Tampa

(813) 565-1521

Shop Our Collection of Wellness Products »

PATIENT FORMS

Step 1

Fill out the Policy and Consent Form

Click the icon below to fill out the form online or click here to download the PDF.

Policy and Consent Form

Step 2

Fill out the Health Questionnaire Form

Click the icon below to fill out the form online or click here to download the PDF.

Health Questionnaire Form

Step 3

Fill out the HIPAA Compliance Form

Click the icon below to fill out the form online or click here to download the PDF.

HIPAA Compliance Form

And you are done! See you soon!