Focused on the Cause, Not just the Symptoms
Informed Consent to Treat (2 pages print in color)
Patient Confidential Form
Health History Form
Please bring any additional information to inform the doctor about Your situation.
FAX the completed and signed form(s) to Dr. Christopher Jackson, Ph.D., D.O.M., at:
E-mail and attach a scanned copy of the completed and signed form(s):
A Path to Wellness. a Holistic Medical Clinic