New Patient Forms

Dr. Larsh New Patient Forms

All New Patients for Dr Larsh:

Please download, print and fill out the appropriate forms below.
Return it to my office by at least a week prior to your visit so I can review it and be prepared for your visit.

All new adult female patients need the following forms:

Female New Patient Questionnaire
Adult New Patient Guidelines
Privacy Policies – No need to print this, though you are supposed to read it and retain a copy.

All new adult male patients need the following forms:

Male New Patient Questionnaire
Adult New Patient Guidelines
Privacy Policies – No need to print this, though you are supposed to read it and retain a copy.

All new pediatric patients need the following forms:

Pediatric Questionnaire
Pediatric New Patient Guidelines
Privacy Policies – No need to print this, though you are supposed to read it and retain a copy.

New patients who have Medicare need to complete these forms:
Virtual visits:

We offer virtual visits (by email or phone) for established patients with very stable conditions that need routine follow up or for those who have relatively simple problems that don’t need face to face contact.

Click here to learn more & schedule a virtual visit.

Amber Weiss New Patient Forms

All New Patients for Amber Weiss:

If you are not an established patient yet, please contact us so that we can provide the best match for your needs:
Amber Weiss, PA-C, LAc is taking new patients for adult primary care, integrative medicine consultations, and acupuncture.
To schedule an appointment with Amber, please email amber@rootsofhealthsc.com or call 831-824-4005.

Please download, print and fill out the appropriate forms below.
It is best if you can bring in your paperwork a few days before your visit so that we can review it and be better prepared for your visit.

Patient Testimonials

Office Location:

709 Frederick Street
Santa Cruz, CA 95062

Hours

Monday to Thursday: 9:00 am to 5:00 pm

Friday: By appointment only

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