New Patients

Please download and fill out all of the General Forms below. 

General Forms
Informed Consent (PDF)  
New Patient Intake (PDF)
Notice-of-Privacy-Practices-EAM (PDF)
New Patient Info (PDF)
Patient Symptom Survey (PDF)


If you are able, please send the completed forms to

When I receive these completed forms we will schedule a brief phone or Zoom consultation. At that time we will make an office appointment for the initial examination and treatment.

If for some reason you are unable to email these forms back to us, please do one of the following:

1. Please call the office and leave a message – Office 858-481-9854

2. Send an email – 

3. Text cell – 760-522-9854

I will return your call ASAP and we will find a solution to that problem.

Thank you…I look forward to seeing you.
Nicolai Lennox, D.C.


You will need Adobe Reader installed on your computer to open and print these forms. If it’s not already installed  on your computer, you can get free by visiting