Forms

New Patient Intake Form

Prior to your first session with Chris, please fill out the intake form and send back to Chris one week prior to our session. This will give Chris time to review. Please include any recent lab work along with the intake form.

 

The intake form may seem quite lengthy, but will give Chris detailed history and background information so you can use your time wisely when you meet. Please set aside 30 mins to fill out the form. 

Existing Patient Intake Form

if you have not seen Chris in over 6 months please fill out the intake form below.  This will update Chris on new medications, supplements, medical conditions, and lab results so she can give you the best possible ​advice and make your time spent together more efficient.

Please fill out and send back one week prior to your session.​

Consent Forms

Prior to your first session with Chris, she will need consent forms filled out and sent back to before you meet. Once the forms are signed and filled out, you can either email, postal mail, or fax it back to her.

 

Please fill out and send back one week prior to your session.​

  • White Facebook Icon
  • White Twitter Icon
  • White Pinterest Icon
  • White Instagram Icon
Chris Latham, MS, CNS, CKNS
P: 805.451.7058
F: 805.324.6218
918 Chapala St, 
Santa Barbara, Ca 93101

Contact me at:

chris@healwellnutrition.com

Certified Nutrition Specialist

Certified Ketogenic Nutrition Specialist

  • Facebook - Grey Circle
  • Twitter - Grey Circle
  • Instagram - Grey Circle

© Copyright 2017 by Chris Latham