Intake Forms


Fill out these simple forms before your first visit.

Keep Us Informed

Please fill out the following forms before your office visit. Also please bring with you any labs, medications, and supplements you are currently taking.

Initial Intake Form – Required for all appointments

Symptom Questionnaire Form – Required for Naturopathic and Medical initial consultations

Initial Complaint Form for Chiropractic – Required for Chiropractic initial consultations

Financial Responsibility Acknowledgment – Required for all appointments

Privacy Policy – You may view this for your reference



Feel free to call our friendly staff, email us or book an appointment online to make an appointment at your earliest convenience.

Contact Us

Optimal Health & Wellness |
Pasadena (626) 788-0023

Optimal Health & Wellness |
Monterey Park (626) 551-5155

Email Us

Contact Us – Monterey Park →

Contact Us – Pasadena →

Book an Appointment Online

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We have two locations, one in Monterey Park and one in Pasadena, CA.

Located At:

Optimal Health & Wellness Pasadena
202 S. Lake Ave. Suite #298
Pasadena, CA 91101
Phone: (626) 788-0023
Fax: (626) 788-0013

Optimal Health & Wellness Center
670 Monterey Pass Road Suite 100
Monterey Park, CA 91754
Phone: (626) 551-5155
Fax: (626) 551-5156