Forms

Health History

For your convenience, the Health History form can be filled out on your computer before submitted to Urban Lotus by email, or may print it and fill it out to bring with you.

Download Health History

Consent

You may print the Consent form to fill out prior to your appointment.

Download Consent

COVID-19 Informed Consent to Treat & Liability Waiver

With the relaxation of restrictions related to COVID-19, we have reopened our clinic and, because our greatest priority is your health and safety, we have implemented a number of new precautions and procedures. One of these is the Covid-19 Informed Consent to Treat and Liability Waiver; this ensures that you have been provided with the information necessary to make informed choices, and understand the risks of receiving care during a pandemic.

Download COVID-19 Informed Consent to Treat & Liability Waiver