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New Patient Documents

Intake & Assessment Forms

All new patients: Please CLICK on and COMPLETE the confidential forms below. All forms must be completed before being seen by Jonathan Glass ND, M.Ac.

  • Consent Form

  • Health Ministry Application Form

  • Patient Intake Form

  • Dosha Test Form

  • Neuro Toxic Test (upon completion email to [email protected])

HEC Health & Safety Guidelines

Prior to your appointment at our offices in Concord, please download and sign our updated HEC Health & Safety Guidelines, June 16, 2020 and return it to us by email.