Before your first appointment…
Please take a few moments to complete the forms below. Each one is designed to help us understand your unique needs, preferences, and health history so we can offer the most personalized care possible.
HIPAA
All forms are fully HIPAA compliant and securely submitted through our system.
1
Patient
Information
This form offers Root Causes a snapshot of your symptom patterns over the past 14 days, helping guide personalized care and identify areas for support.
Estimated Time:
8 – 12 mins
2
Enrollment
Consent
A supportive overview, that helps you understand the heart of functional medicine, your relationship with our team, and the program details.
Estimated Time:
4 – 5 mins
3
Medical Symptoms
Questionaire
This form offers Root Causes a snapshot of your symptom patterns over the past 14 days, helping guide personalized care and identify areas for support.
Estimated Time:
5 – 7 mins
Form 4 is for cancer patients initial screening visit with Dr. Lucas only.
4
Cancer patient
screening
This form gives Root Causes a personalized view of your health journey to date, helping us tailor your care for the screening appointment.