Forms

Below are links to our Patient Forms and Health Questionnaires that we may ask you to fill out. Please check with our office to see which of these forms you will need to complete.

When you click on a form, it will open a PDF file in a new window for you to print, fill out, and bring with you to your appointment. Be assured that Dr. Sholl will personally review every form and questionnaire that you fill out.

If you have any questions, please give us a call at (207) 289-1060

  1. Medical Symptoms Questionnaire.pdf
  2. Adult Medical Intake – Part 1.pdf
  3. Adult Medical Intake – Part 2.pdf
  4. Adult Medical Intake – Part 3.pdf
  5. Environmental Sensitivity Questionnaire.pages.pdf
  6. Toxin Exposure Questionnaire – Adult.pages.pdf
  7. Toxin Exposure Questionnaire – Child.pages.pdf
  8. Environmental Exposure History Form.pdf
  9. Functional Medicine Pediatric Questionnaire
  10. Pediatric Questionnaire Addendum