Dr. Cecilia Hart, N.D.
&
Dr. Elizabeth Korza, N.D.
of
Berkeley Integrative & Naturopathic Medical Group
MEDICAL INTAKE FORM
Please follow the links below to print the appropriate forms.
Please fill the Intake Form out before your appointment. This will save you a considerable amount of time during your Initial Comprehensive Consultation.
Please fill out and send the Medical Records Release Form to your provider well before your appointment date to allow them time to respond. Thank you!
