Prior to your first visit, there are 3 things you will need to prepare for your visit:

Intake forms for you to fill out for yourself or your child. You can download these at the bottom of the paragraph, request that Dr. Schikowitz send them to your home, or pick them up at the clinic. The forms include a number of questions addressing diet, lifestyle, past medical history, and family medical history. They also include consent and release forms. Please take time to fill these out completely. All the answers are important in understanding you or your child as a whole person and will greatly aid in the evaluation of your health conditions. Please allow yourself some time to fill out the paperwork before your visit.
Bring in any medications, vitamins and supplements being taken.
If you have a copy of recent labs, bring those as well.

If you feel that your concern may be diet-related, please consider printing the diet diary instructions and filling out diet diary form below.

Thanks you for your cooperation and effort to create the most effective visit for you possible.

Download Intake forms:

Adult and Adolescent Intake (PDF)
This is a long form. Filling it out will allow us to cover a lot of material during your visit.
Please make sure you give yourself enough time.

Pediatric Intake (PDF)

Diet Diary Forms:
These are optional but helpful. You can do a 1 to 3 day diet diary if you believe it will help with your assesment.

DIET DIARY INSTRUCTIONS (PDF)

Diet Diary (PDF)

Other Forms:

Records Release 2 (PDF)
Use this to give to your other healthcare providers to get medical records.