Health Profile

The following form is provided so we can get a basic understanding of your current wellness situation.  It is involved because wellness is a very involved process.  The body has many intricacies and its organs and systems have very delicate relationships with one another and our environments.  Imbalances in any of these can lead to pain, sickness, depression, weight gain or a host of other symptoms.  By filling this form out to the best of your ability, you are better able to help yourself and help us help you.

Some questions may seem sensitive to you, but, by law, all of the information you give us is protected and only Dr. Paul Kwik and our trained Health Coaches -- only when they are involved in your direct care -- will ever see the information on this form.  It will not be shared with anyone else.  If you still do not wish to share certain information with us, it is your right to do so, but please remember that not sharing this information limits our ability to treat you and, therefore, limits your body's ability to heal itself.