Patient Forms

Take the first step in improving your health by filing out the required forms

Below you will find the required forms to become a participant in our programs. Ideally, complete your forms securely online. If necessary, you may also print and send them to us

Ideal Protein

Must have

Ideal Protein Health Profile Form

Optional

Physician’s Release To Participate

(physician to complete)

Payment Authorization

Download all

Must have

Secure Payment Authorization - All Programs - New Form

Must have

Secure Payment Authorization - All Programs

Must have

Payment Authorization

Complimentary Consultation Form

Patient Forms

Must have

Complimentary Consultation Intake

Customized Nutrition New Patient Forms

Patient Forms

Not for Ideal Protein Clients

Must have

New Client Intake
Form

Optional

Upload Lab
Results

(multiple files ok)

Optional

Records Release
Form

(valid for 90 days)

Customized Nutrition Follow Up Session

Must have

Returning Patient Session Update
Form

Optional

Records Release
Form

(valid for 90 days)

Optional

Upload Lab
Results

(multiple files ok)

Metabolism (RMR) Testing Intake Form

Must Read

Metabolic Testing Preparation

My Drafts

Here are the forms you started filling out, but something interrupted you. You can continue from the step you stopped

Ideal Protein Consent To Participate (draft)

Top Arrow