Client Forms

Below are all of Synergy FWC Client Intake Forms.

Please complete the form that coincides with the appointment you would like to schedule. Thank you!

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Virtual "Doc on Demand"

Form (Adult/Child)

This form is for a clients who are looking for guidance on one health topic of concern or recommendations.

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Elite Coaching Client

Form

This form is for new clients applying for our coaching program.

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Grocery Shopping

Experience Form

This form is for clients requesting a grocery shopping experience.

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Virtual Consultation Form (Adult)

This form is for new clients who are looking for an overall health transformation.

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Professional Detox Support Form

This form is for new clients enrolling into our detox/cleansing program.

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Healthy Home Makeover Experience Form

This form is for clients requesting a home makeover experience.

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Virtual Consultation Form (Child)

This form is for parents to complete for their children who are new clients to Synergy.

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Lab Testing Services 

Form

This form is for new clients requesting lab services with Synergy.