Intake Form

There’s one reason why ViaVitae Health has become the premier chronic pain and illness clinic in the area… and that’s because of the incredible dedication and work of Dr. Robert Inesta.

Schedule your New Patient consultation today and meet us!

Start Your Journey Back To Health

The intake form is one of the most important aspects of your program because it gives us a close look at your medical/social history and current health status. It usually takes between one to two hours to complete.

Please take your time telling your story and fill out the form to the best of your ability. The more we know, the better we can help you. If you are not sure how to answer, simply leave a question mark next to the question.

 

 

Please follow the instructions below carefully.

***IMPORTANT***
This form must be saved and filled out in Adobe or printed and filled out manually. DO NOT fill it out in your browser or you will lose your work.

You may send the filled out form to info@viavitaehealth.com once completed or bring it to your consultation.

Please click button below to download the form.

Testimonials From Patients

“The Team At Infinite Wellness Is Life Changing…”

From the moment I walked through the doors at Infinite Wellness, the entire staff and medical team there have been SO helpful! From helping me schedule my initial appointments to answering any questions I had about my treatment, they always knew exactly what to say, and how to help.

“My Wife Is Finally Feeling Better, And She’s Happier Than Ever…”

My wife and I seemingly have traveled from city to city in search of someone who could help with her chronic pain. Luckily, the last stop we had to make was in Boston, where Dr. Woods and his team at Infinite Wellness provided the perfect diagnosis for my wife. She couldn’t be happier and has recommended Dr. Woods to all her friends!