Millar Functional Medicine

(256) 513-4888

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    • Home
    • About Us
      • About Us
      • Clinic Pictures
      • Providers
      • Staff
    • Services
      • Functional Patient
      • Wellness Boost Patnent
      • 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
    • Wellness Boost Patnent
    • 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

Consultation or Discovery Call Download Forms

Functional Medicine Patients download and fill out MFM Form A1 Consultation and Forms B, C, D, and E.  

Therapy Patients download and fill out MDM Form A2 - Discovery Call and 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 a consultation with the Millar Functional Medicine Doctor.

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 NOTICES, Disclaimers and Disclosures:

Copyright © 2016-2026 Millar Functional Medicine, LLC. All Rights Reserved. 


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


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. 


a Discovery Call or Consultation visit DOES NOT establish a doctor-patient relationship or a new patient of Millar Functional Medicine. 


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


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