New Patient Forms


All forms can be filled out on my online Healthie platform for seamless and secure exchange of your health information.  Once you make a new patient appointment and login to Healthie you will be guided in this process.

You can also fill out by hand and mail to me c/o Avalon Yoga and Wellness Center, 10 Winters Lane, Catonsville, MD  21228 or you can fax to me at 443.478.4700.

All intake forms are required prior to your initial consult. Also, please bring any supplements or recent labs to your visit, or send in advance through Healthie if you are meeting by teleconference or phone.

Thank you!

For follow-up visits, please fill out the RSN MSQ Health Form below and bring a 2 day food diary.



RSN Cover Letter

RSN Adult Health Questionnaire – please download and save to your computer prior to filling this out

RSN Youth Health Questionnaire – if under 13 years of age, please fill out this form