Patient Forms

Your Privacy Matters

We take your personal security seriously! Therefore, we use an online encryption tool to ensure your personal information is encrypted and protected, whether you are filling out your comprehensive health history or asking me a question. Your personal health information is protected, secure and HIPPA Compliant through intakeQ, our online medical forms provider.

After your free 30-minute consultation and we’ve decided to move forward I will send you a secure email link to fill out your medical intake forms and the client engagement forms. These are all able to be filled out and signed online or printed and filled out.

We use this same encryption tool when you fill out the form, Ask Cindy a Question or Send Cindy Personal Health Information. You can find the links to these forms below. You’ll be asked to first provide your name/email address and after that, you’ll be routed to a secure messaging system where you can fill out these forms.

Ask Cindy A question

Send Cindy Personal Health Information

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