New Patient Intake Form

Instructions and Reminders

Thank you for choosing Central Ohio Nutrition Center for you continued medical care!

Our intake forms will be easiest to fill out on a desktop or laptop computer. For best results, please use Google Chrome or another modern desktop browser. Please complete all assigned forms at least 90 minutes prior to your appointment time. If you cannot do this, plan to arrive 30 minutes before your appointment time.

These forms take about 25-30 minutes to fill out. Each page saves individually when submitted. You can submit any number of pages and return to the rest at a later time. Be sure to use the same email address on each page.

If a field is required that doesn't apply to you, enter "N/A" in the field or pick the most relevant answer.

Appointment Reminders

Please allow 90 minutes to 2 hours for your first appointment.
If having blood work done
- You must be fasting for 8 hours
- Drink plenty of water and other caffeine-free, non-caloric beverages
- Take medications you can tolerate on an empty stomach
- You may bring something to eat after your lab draw takes place so you can take the rest of your medications
If you will be having a metabolism test
- You must be fasting for 4 hours prior (Water is ok)
- No exercise or caffeine for 4 hours before
- No smoking or use of nicotine for 1 hour before
- No alcohol for 3 days before.