Intake Forms
Dr. Andrew Kim
Naturopathic Physician - Acupuncturist
Practitioner of Chinese Herbal Medicine
GroundSpring Healing Center
8283 SW Barbur Blvd, Portland OR 97219 phone: 503-244-7331 fax: 503-662-6344
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.