Online Forms

Optimal Wellness Center offers our patient forms online so they can be completed in the convenience of your own home or office.

• If you do not already have AdobeReader® installed on your computer, Click Here to download.
• Download the necessary form(s), print it out and fill in the required information.
• Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, and goals regarding wellness can we help you with? Let us know! This form is currently available in office at the time of your new patient appointment. You will also be asked to to sign our privacy policy prior to your visit with Dr. Nielson or Dr. Dunn.

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Auto Accident Information Form - Required for all new Auto Accidents

This sheet provides us with the necessary auto insurance and accident information to properly bill the involved insurance companies for your treatment. Utah is an No-Fault state, which means that your insurance company, or that of the vehicle you were in at the time of the accident, must cover your recovery costs for the first $3,000. Please read the instructions posted at the bottom of this form before completing it. You will be asked to sign an additional privacy/consent form upon arrival for your new injury examination.

Coming Soon

New Massage Client History Form - Required

At Optimal Wellness Center we ask that all those who schedule with our massage therapists for private sessions complete this form. The questionnaire section is designed to help your therapist better understand the type of massage that would be most beneficial for you. They will always discuss any questions you may have before beginning your session.

Coming Soon

Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues, news, and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!