Please fill out each form to the best of your knowledge. We need to know as much information as possible to be able to help you in the best way we can. You will also be required to bring your ID to your first appointment. Click on the forms to the right to access them and feel free to contact The Youth Fountain if you have any questions or concerns.
Please fill out each form to the best of your knowledge. We need to know as much information as possible to be able to help you in the best way we can. You will also be required to bring your ID to your first appointment. Click on the forms below to access them and feel free to contact The Youth Fountain if you have any questions or concerns.
The Youth Fountain Female Anti-Aging Registration Packet consists of the patient’s general information, HIPAA disclosure form, and the intake forms. You will need to fill out these forms if you are a first time patient receiving Anti-Aging services. Please click below to access and fill out.
The Youth Fountain Male Anti-Aging Registration Packet consists of the patient’s general information, HIPAA disclosure form, and the intake forms. You will need to fill out these forms if you are a first time patient receiving Anti-Aging services. Please click below to access and fill out.
The Youth Fountain Weight Loss Form History includes general patient information, HIPAA disclosure form, and the intake forms . You will need to fill out these forms if you are a first time patient receiving Weight Loss services. Please click below to access and fill out
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