Intake Forms

Please fill these out ahead of time, or come to our first appointment 10-15 minutes early to fill out the appropriate paperwork. Bring any relevant medical records, x-rays, MRI, etc.

Chief Complaint
New Patient Contact
Financial Policy

Functional Medicine and Neurological Intakes

Please allow two hours and fill out the Metabolic Assessment Form and the Brain Region Localization Form.

Metabolic Assessment Form
Brain Region Localization Form

If you have dizziness or vertigo, please fill out the Vestibular Localization Form.

Vestibular Localization Form

Consultation Process

A typical session with Dr. Leopold starts with a thorough medical history and examination followed by a variety of treatment modalities, corrective exercises and possible lifestyle recommendations. If necessary, x-ray, MRI or blood work may be ordered.

Need more information? Get in touch!

Get In Touch
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