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New Patient
​Consents

Online Form

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You will receive this form in an appointment reminder one week prior to your new patient visit. This consent is required for all new patients who have not been seen at IFM. Please complete this prior to your appointment. If you have already filled this out, you do not need to complete it for each recurring follow up visit.

New Patient
​Intake

Online Form

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You will receive this form in an appointment reminder one week prior to your new patient visit. Completing this form one week prior to your appointment assists your provider in getting to know you better.

IV
​Consent

Online Form

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Please complete the IV consent prior to your IV appointment. This consent is required prior to infusion. Once you have filled this out, you do not need to fill it out again for repeat IV infusions.

​Records
​Release​ 

Online Form

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To save time, please complete this form 1 day prior to your appointment so that our provider can review and prepare for your appointment.

GAD 7 Anxiety Screening Form

Online Form

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Your provider may request that you complete this form during or after a visit.

PHQ9 Depression Screening Form

Online Form

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Your provider may request that you complete this form during or after a visit.

Alpha-Stim
​Rental form

Online Form

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This is for patients who are renting an Alpha-Stim. A provider new patient visit is required to rent this device.

ADHD
​Screening Form

Online Form

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Your provider may request that you complete this form during or after a visit.

Do you have questions?

Visit our our FAQ page to find answers to your questions, you can always contact us. We will answer you shortly!

(515) 218-1399

We are always happy to help you

info@integrativemediowa.com

info@integrativemediowa.com

The best way to get an answer faster