Intake Forms

Please do not fill out any of the patient forms unless you have contacted the clinic first.

 

Please have enough time, about 15 minutes, to fill out the intake form. If you must leave it and return at a later time, the site will ask for a passcode-  you will receive that in a separate message from the form application “IntakeQ.”

The Confidential Patient Intake Form can be found Here.  

Please contact us directly with any questions or technical issues.

Thank You,

The Duquette Functional Medicine Team!