We are excited to welcome you to Viva Wellness & Injury!

To ensure a smooth and efficient experience during your upcoming appointment,
please complete our NEW PATIENT INTAKE prior to your appointment.

• Complete the forms electronically on your computer or most smartphones using any compatible PDF software/reader. Or Print the forms and complete using pen/pencil.
• When using a mobile device, save the PDF to your device if autofill options are not presented.
• Please be sure to complete accurately – each section highlighted in yellow
• This form does not allow for e-signatures – We will have you sign in-person during your initial visit
• Save/Scan the completed forms and email them to us at records@myvwi.com
• Or you may print the completed forms and bring them with you to your initial visit.

Thank you for helping us streamline your visit. We look forward to providing you with excellent care!