ND General Intake Form
ND Patient Informed Consent and Acknowledgement
Chelation Therapy Consent
Intravenous Therapy Consent
Polo Pediatric Intake Form
Colon Hyrdotherapy Consent Form
Colon Hyrdotherapy Intake Form
Counsellor Intake and Consent Form
Dietitian Intake Form
Dietitian Consent Form
Holistic Nutrionist Intake Form
Intake and Consent
Office Policies
General Intake Form
Botox Consent
Fillers Consent Form
General Intake Form
Bio-Identical Hormone Consent Form
Privacy of Information and General Clinic Policy
Polo Health + Longevity Centre
711 Columbia Street
New Westminster, BC V3M 1B1
Located in the Heart of New Westminster, BC
and proudly serving Vancouver and the
entire lower mainland,
T: 604-544-7656
F: 604-544-7657
E: info@polohealth.com