All applicable information must be filled out to see the practitioner. Please only submit this form if you are currently ready to work with Brenda and have read all disclaimers, also there is a $50 initial appointment retainer fee to hold/book your initial appt.

Thank you for choosing Passionately Well Naturopathic Wellness & Counseling Transformations to assist you with your wellness journey. Our ability to draw effective conclusions about your state of health and how to optimize improvements depends largely on the accuracy of the information in which you provide, including symptoms that you may consider minor or symptoms that have become “normal” to you. Health issues may be influenced by many factors; therefore, it is important that you carefully consider the questions asked in this form as well as those posed by the practitioner during your consultation. This will assist our goal to provide you with an optimal plan of wellness care, enhance our efficiency, and will provide effective use of your scheduled time.

Please complete the form in it’s entirety. Should you have any questions, feel free to reach out and let us know.