Naturopathic Medicine Health History Form

This comprehensive health history form is tailored for naturopathic physicians and integrative medicine practitioners who take a whole-person approach to patient care. Unlike conventional medical histories, this template captures the extensive lifestyle, environmental, nutritional, and emotional factors that naturopathic doctors consider essential for understanding root causes of illness. The form explores dietary patterns, supplement usage, exercise habits, sleep quality, stress management, toxic exposures, spiritual wellness, and mind-body connection factors that influence health outcomes.

The template includes detailed sections on current and past use of natural therapies including herbal medicine, homeopathy, acupuncture, bodywork, and energy healing modalities. It systematically assesses digestive function, hormonal balance, immune health, detoxification capacity, and constitutional factors central to naturopathic diagnosis and treatment planning. The form also captures family health patterns, childhood health history, birth history, and generational exposures that may impact current health. This thorough approach enables naturopathic doctors to develop personalized treatment plans that address underlying imbalances and support the body's innate healing capacity through natural, non-invasive therapies.