ALEXIS CHESNEY MS, ND, LAC
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New Client Forms
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If you scheduled an appointment at the private office via telehealth, please download the following forms. Fax the forms to the private office fax number (888-257-8036) before the telehealth consultation.
​Please note that these are not the forms to use if you will be seeing Dr. Chesney at Sojourns Community Health Clinic.
Intake Form (private office)
File Size: 140 kb
File Type: doc
Download File

Symptom List
File Size: 15 kb
File Type: pdf
Download File

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