Naturopathic Family Medicine Appointment Request

Please review and complete this form to request an appointment.

    Thank you for your interest in Intuition Wellness Center. Here is some information that may be helpful:

    • Intuition Wellness Center medical services serves children ages birth and up and their caregivers.
    • Self pay fees for services are available to view on our Fee Schedule.
    • Naturopathic medical services are not billed directly to insurance. You may request a superbill.
    • If you are seeking information on our Wellness Programs, you are not required to complete the following questionnaire.
    • The questionnaire below is required in order to determine Intuition Wellness Center’s ability to meet your needs. To request services, please call 520-333-3320 or complete the following prospective client questionnaire:

      Self (adult)ChildFamily


      Health ProfsSana NetworkInternet (eg., Google)PCPOther ProfessionalOther

      Get EstablishedWell Baby/ChildSports PhysicalSick-AcuteOther

      YesNoNA, prospective client is an adult

      YesNoNA, prospective client is an adult

      Please supply supporting court documents at intake or scan and email them to prior to your intake appointment.

      MedicalBehavioral HealthOtherNone

      If you have previous behavioral health or medical treatment history, please bring a copy of records (e.g., treatment summary, treatment plan, testing reports, etc) at the initial intake appointment. You can also email PDF documents to

      Thank you for taking the time to complete the questionnaire. Please click “Request an Appointment” to submit to the Intuition Wellness Center team for review and processing.