Printable Forms
The following forms require Adobe Acrobat Reader to open and print. If you need to install Adobe Acrobat Reader, click on the link to download the free Adobe Reader software directly from Adobe's website.
New Patients
Please download, print and complete the Patient Information Sheet which includes the HIPAA Policy Required Authorizations form and bring them with you to the office to save time on your initial visit.
Nutritional Analysis Forms
Please download, print and fill out the Symptom Survey, the Toxicity Questionnaire, and the Daily Record of Food Intake and either fax them to McKinzie Wellness Center at 903-531-2248 or bring them when you come for your appointment.
The Systems Survey Maestro program has been designed to carefully evaluate the individual patient's nutritional needs. This greatly enhances the efficacy of the recommended supplements and prioritizes the patient's support needs.
Symptom Survey
The Toxicity Questionnaire helps determine a patient's need for the Purification Program.
Toxicity Questionnaire
The Daily Record of Food Intake helps to record everything you eat and drink each day.
Daily Record of Food Intake