INTEGRATIVE CARE NJ
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Policies and Forms


For your initial visit, please complete the forms at the right. It is essential for the completed forms to be received at least 1 week prior to your appointment.

Please print and mail completed forms and initial deposit to:

INTEGRATIVE CARE NJ
134 Main Street, 2A
Flemington, NJ 08822

(Note that additional forms may be sent depending on the reason for your visit.)
  • Directions for completing forms
  • Contact information
  • Recent medical data
  • Adult questionnaire (part 1)
  • Adult questionnaire (part 2)
  • Medical symptom questionnaire
  • Toxicity questionnaire
  • Stress questionnaire
  • Walsh Approach Health History Form*
  • Fee schedule/insurance waiver
  • Credit card form


*Please complete only if you are considering an evaluation for mood disorder using the Walsh Approach.
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