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Step 1: Fill out this Registration Form so we have your information on file and once it has been submitted you should be taken to our Authorization Page:

Step 2: Complete the Appropriate Authorization by printing and faxing or by filling it out and signing it Electronically. You should be taken to that page once this form is, successfully, submitted.
If not, Click Here for Authorization Page.
Select New Client or Introductory call depending on you preference

For Standard New Clients: Once we receive BOTH the Registration Form AND signed completed New Client Authorization, we will create your client file and contact you for an appointment. You should hear from our office upon submission of this form (make sure you have a valid e-mail) within 24 hours. If not, please call Karen at 305-652-5372 or e-mail office@naturalholsitic.com.

For Introductory Consult Clients: Once we receive BOTH the Registration Form AND signed completed Intro Authorization, we will contact you for an appointment. You should hear from our office upon submission of this form (make sure you have a valid e-mail) within 24 hours. If not, please call Karen at 305-652-5372 or e-mail office@naturalholsitic.com.

 

New Client Registration Form (12-2013)

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