New Patient Forms

Optimized Wellness Center offers our patient forms online so they can be completed in the convenience of your own home or office.

If you do not already have AdobeReader® installed on your computer, Click Here to download.
Download the necessary forms from the list below that pertain to your visit, print them out and fill in the required information.
Submit them via email 24 hrs prior to your first appointment.

Practice Member Application*

*This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

I was suffering from lower back pain for 5 years. I had pain going down my leg and difficulty walking. I was also suffering from knee and foot pain and severe neck pain. My pain was so severe that I was on pain and anti inflammatory meds (Vicodin, Ibuprofen). I was treated by other Chiropractors and I they did not take the time to get to know why I was hurting. I would just get a quick regular adjustment and they would send me on my way. Tim took time to get to know me, for example: he walked with me outside to see how I was walking, he wanted to see how I sat in a chair and wanted to know how I set my chair at home and he also gave me bed recommendations; all of his recommendations were extremely helpful. I think Tim’s personal approach helped me get over any doubts I had about treatment. I think its natural to apprehension and questions when dealing with new information regarding health and wellness. Before Tim introduces something he thinks may be helpful he always educates you on the subject. Even when he does minor adjustments he always asks for permission and explains what and why he is doing during the treatment session. I felt at ease during my fist treatment. The office doesn’t feel clinical. Its very open and has a welcoming vibe. The front office staff was very friendly and seemed genuinely interested in how I was feeling. I also liked the upbeat music that was playing. Additionally, I loved the fact that they don’t leave me waiting. A 12:00 appointment really means a 12:00 appointment!!! After my first treatment I felt an overall reduction of pain in my lower back. Tim called and checked up on me after my treatment which I thought was very professional. After roughly 90 days I was able to start decreasing my meds and after about a year I was completely off meds. Tim encouraged me to do exercises and stretches on my own. After about a year I was pain free and healed. I still see Tim quarterly for adjustments but its just for maintenance because I no longer require adjustments for pain reduction. I would totally recommend Optimized Wellness Center for anyone looking to truly heal and learn to heal themselves. I was a in debilitating pain and Optimized Wellness Center helped me get back on my feet.

Malcolm W.

New Patient Forms

Optimized Wellness Center offers our patient forms online so they can be completed in the convenience of your own home or office.

Practice Member Application*

Medical Release Form

Privacy of Practices

Practice Member Re-Evaluation

Lab Testing Preparation

Telemedicine Form

Short Intake Form for Therapies

Patients Love What We Do!
⭐⭐⭐⭐⭐

3800 Piedmont Ave., Oakland, CA 94611
Free 15 Minute Initial Phone Consultation

Now Accepting New Patients: (510) 497-4424

Optimized Wellness Center

Resources

Recent Blogs

Creating a Diet Plan – Where to Start?

For Better Heart Health

New Patient Forms

Optimized Wellness Center offers our patient forms online so they can be completed in the convenience of your own home or office.

Practice Member Application*

Medical Release Form

Privacy of Practices

Practice Member Re-Evaluation

Lab Testing Preparation

Telemedicine Form

Short Intake Form for Therapies

Patients Love What We Do! ⭐⭐⭐⭐⭐

3800 Piedmont Ave., Oakland, CA 94611 Free 15 Minute Initial Phone Consultation

Now Accepting New Patients: (510) 497-4424

Optimized Wellness Center

Resources

Recent Blogs

Creating a Diet Plan – Where to Start?

For Better Heart Health

Patients Love What We Do!
⭐⭐⭐⭐⭐

3800 Piedmont Ave., Oakland, CA 94611
Free 15 Minute Initial Phone Consultation