Your Next Step
Health Intake Questionnaire
Root Restore Health uses Practice Better for its 42-question assessment and required acknowledgments.
Before You Begin
Continue to Practice Better
The previous print-and-email questionnaire has been retired. Please use the Practice Better assessment so your responses, acknowledgments, date, and electronic signature stay together for review.
1. Set aside timeAllow about 10–15 minutes and complete the assessment in one sitting when possible.
2. Complete each pageAnswer the 42 symptom questions and the additional history fields.
3. Review and submitComplete the required acknowledgments, date, and electronic signature.
Eligibility and review: Root Restore Health provides virtual health education and wellness consulting to adults age 18 and older only. International inquiries are welcome and reviewed individually; services are offered only where permitted by laws applicable in the prospective client's location. Root Restore Health does not diagnose, treat, prescribe, or provide emergency medical care. For an emergency, call 911 or your local emergency service. Submitting the assessment creates a prospective-client submission for review. It does not establish a client relationship, guarantee acceptance, or book an appointment.