Intake Forms
Dr. Andrew Kim - Naturopathic Physician - Chinese Medicine
The Healing Arts Clinic - an association of independent practitioners
3644 SW Troy Street, Portland OR 97219 phone: 503-244-7331 fax: 503-977-0502
Please download the appropriate Intake Form and bring it with you, completed, to your visit.
If you do not have access to a printer, please call our office and we will be happy to mail you a copy.
Pediatric Intake, Ages 0 to 5 Years
Pediatric Intake, Ages 6 to 12 Years
Physician Referral Intake
For patients referred by their primary care physicians for Food Sensitivity Testing only
You may need Adobe Acrobat to view and print these forms. The latest version can be downloaded for free here.