Millar Functional Medicine

(256) 513-4888

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    • Home
    • About Us
      • About Us
      • Clinic Pictures
      • Providers
      • Staff
    • Services
      • Functional Patient
      • Functional Medicine IV's
      • Functional Med Injections
    • Conditions
      • Conditions We Treat
      • Gut Issues and Gut Health
      • Optimal Health
    • Therapies
      • Therapies
      • Regenerative Medicine
    • Wellness BOOST
      • Wellness Boost Patient
      • First Time IV With Us
      • MFM Wellness Boost IV
    • Contact
      • FAQ
      • CONTACT US
      • New Patients
      • Legal

(256) 513-4888

Millar Functional Medicine
  • Home
  • About Us
    • About Us
    • Clinic Pictures
    • Providers
    • Staff
  • Services
    • Functional Patient
    • Functional Medicine IV's
    • Functional Med Injections
  • Conditions
    • Conditions We Treat
    • Gut Issues and Gut Health
    • Optimal Health
  • Therapies
    • Therapies
    • Regenerative Medicine
  • Wellness BOOST
    • Wellness Boost Patient
    • First Time IV With Us
    • MFM Wellness Boost IV
  • Contact
    • FAQ
    • CONTACT US
    • New Patients
    • Legal

Discovery Call and Consultation Download Forms

All prospective new Patients download and fill out MFM Form A2 - Discovery Call and Forms B, C, D, and E.  


MFM Form A1 - Consultation (pdf)Download
MFM Form A2 - Discovery Call (pdf)Download
MFM Form B Personal Information (pdf)Download
MFM Form C Health Information (pdf)Download
MFM Form D Review Of Systems (pdf)Download
MFM Form E - Pain Chart (pdf)Download

New Functional Medicine Patients Download Forms

Please do NOT fill out these forms until you have had your consultation with the Millar Functional Medicine Doctor or Nurse Practitioner

MFM - New Patient Intake Formfil (pdf)Download
CDC Food Diary (pdf)Download
CDC Stool_Diary (pdf)Download
CDC Sleep-Diary (pdf)Download
MFM - Past Doctors List (pdf)Download

HIPAA and Legal Notice

Please download and fill out before your Consultation Visit. This will save time for you sitting in the clinic.

HIPAA Privacy Notice Handout (pdf)Download
HIPAA PATIENT CONSENT Form (pdf)Download
MFM - EHR Access Form (pdf)Download

LEGAL NOTICE, and Disclosures:

Copyright © 2012-2026 Millar Functional Medicine, LLC. All Rights Reserved. 


The content of this site has not been evaluated by the Food and Drug Administration or any other State of Alabama or Federal GOVERNMENTAL agency. 


Results Vary Patient to Patient. Past Positive outcomes are no guarantee of future results. No Guarantee of outcome or results are made either EXPRESSED OR IMPLIED.


For more Legal Notices and Disclosures see Legal under Contact tab.

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