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12734 Kenwood Lane #84

Fort Myers, FL 33907

Call Us: (239) 425-2900

Call Us: (239) 425-2900

Home
About Us
Services
Functional Medicine
Anti-Aging
Patient Education
Forms
Contact Us

Forms

Download patient form(s) by clicking the links below.

Informed Consent For Intravenous Nutravenous Treatment

Informed Consent For Intravenous Nutravenous Treatment

HIPAA Privacy Notice

HIPAA Privacy Notice

Informed Consent

Informed Consent

New Patient Intake

New Patient Intake

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Copyright © 2018 Root Causes Holistic Health and Medicine
All rights reserved.

IMPORTANT! All information presented in this website is intended for informational purposes only and not for the purpose of rendering medical advice. Statements made on this website have not been evaluated by the Food and Drug Administration. The information contained herein is not intended to diagnose, treat, cure or prevent any disease.

12734 Kenwood Lane #84,
Fort Myers, FL 33907

Call Us: (239) 425-2900

Copyright © 2018 Root Causes Holistic Health and Medicine
All rights reserved.

IMPORTANT! All information presented in this website is intended for informational purposes only and not for the purpose of rendering medical advice. Statements made on this website have not been evaluated by the Food and Drug Administration. The information contained herein is not intended to diagnose, treat, cure or prevent any disease.

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