Welcome to Elk Grove Naturopathic Medicine. We look forward to working with you and being a part of your health/wellness team. We offer a fragrance-free environment in our office to protect our staffs and patients who have chemical sensitivity. Please do NOT wear perfume, cologne, body fragrance (including lotions, deodorants), hair products, etc to your appointment. If you are bringing guests to the appointment, please advise them of our fragrance-free policy.

For New Patients

Please fax, mail or drop off completed medical history & consent forms, copies of your medical records/labs/imaging, diet diary, and any other forms as directed by our staff at least 2 days prior to your appointment date.

• Adult Intake Form
• Pediatric Intake Form (11years old and younger)
• Consent forms
• Diet Diary

All Forms

• New Patient (Adult) Intake Form
• New Patient (Pediatric) Intake Form
• Consent forms
• Diet Diary
• Blood Pressure Diary
• Body Temperature Diary
• Homeopathic Intake form (fill out this form if you are seeing Dr. Chhun-Lum for a homeopathic remedy)
• Notice of HIPPA (You do not need to print this out. It’s for your reference)