Forms

Here are most of Dr. Bob’s forms to complete before your first visit.  Please add your Email address to page 1 of Intake Form, and email to  bob@drbobdick  or snail mail them to me at 507 Burgess Rd, Apex, NC 27523.  You’ll come 15 minutes early to be sure to be on time. Click on each form to download the files in .pdf format, & please remember to find & add phone numbers for each of your other healers, and your own email address.

Agreement Form

Consent for Release Form — please Remember to supply phone numbers & Email address

Limits of Confidentiality Form

Symptoms Form

Intake Form

Note that all forms are in .pdf format.  If your computer cannot open .pdf files, please download the free Adobe Reader by clicking here: Adobe Reader.

To see my wife’s site  PeggyPayne.com