Forms

Before your Initial Intake Appointment, please download, print, and fill out these two forms:

1. Intake Form
2. Disclaimer

Allow for 20-40 minutes. The intake form contains a 4-day diet journal so please plan accordingly.

It’s ideal if you can return the forms to us 2 days before your appointment so your nutritionist can review in advance and start formulating your plan. This helps to maximize your time together.

Options to return the intake forms:

Download, complete the fillable form, re-save and email the completed copy to support@BeBalancedHealing.com

OR

Download, print and fill out the form by hand, then:

  • Scan and email the completed copy to support@BeBalancedHealing.com
  • Drop off at our office (350 Broadway, Suite 200, Boulder, CO 80305). You may leave it at the front desk on a Monday – Friday.
  • Mail to 350 Broadway, Suite 200, Boulder CO 80305

OR

If neither of those options is possible, please bring the completed forms to your appointment.
Thank you!

Are you ready to schedule?

Click here to schedule an appointment online.
Choose either the “Meet & Greet” or “Initial Intake Appointment.”