Consultation Intake Forms

Follow the Instructions below how to properly download, fill, save and email the forms to Christine Rosche.

Step 1) Download and save the forms to the computer

Download Primary Intake Form

Step 2) Right click on the downloaded forms and choose open with – please select Adobe Acrobat

If the Adobe Acrobat is not installed on your computer please download it and install it for free from Adobe website

Step 3) Fill the forms
Step 4) Choose from File menu – SAVE AS – please rename the PDF form with your first and last name. Notice the location you are saving the form to your computer. You will need that in the next step.
Step 5) Please attach from the locations you saved the forms to an email and send the Primary Intake PDF Forms and Digestive Health Assessment Form via email 24 hours before your appointment time to

Download Digestive Health Assessment Form

Total Toxic Burden Assessment

Office Policy Form – Please sign and Date

Client Informed Consent – Please sign and Date

For distance clients, please download, print, fill in, scan and send via email attachment.

Christine’s Essential Cleansing Intake Forms:

Detox Intake Sheet
Toxicity Questionaire
Nutritional Supplement Intake Form
How Does Your Diet Rate
Detoxification Brochure

* All documents are in Adobe PDF format. Download the free Acrobat Reader