New Patients

Thank you for considering The Wellness Way – Shipshewana for your health needs. Let’s get started!

These forms cannot be filled out using a tablet or mobile device as they are not compatible. PDF files must be saved to your desktop before and after completing! You must have Adobe Reader DC installed to save these forms. You can download and install the FREE version

Step 1

Complete the Health History Questionnaire. Email this document to shipshewana@thewellnessway.com.

https://thewellnessway.com/forms/shipshewana/health-history.pdf

Attention Parents/Guardians:

If you have a child aged 17 or under, you must complete the Pediatric History Form, not the Health History Questionnaire. Email this document to shipshewana@thewellnessway.com

https://thewellnessway.com/forms/shipshewana/pediatric-history.pdf

Step 2

Print out and complete the Signature Pages. Bring these forms with you to the office for your first appointment!

https://thewellnessway.com/forms/shipshewana/signature-pages.pdf

Step 3

Complete the Functional Assessment Questionnaire online. This health review takes approximately 30 to 40 minutes to complete. FAQ instructions.

https://faq.thewellnessway.com/?accountID=43975209&u=415290769594460e2e485922904f345d