Contact : 302-777-0778

Online Forms

Synergy Integrated Medical Center offers our patients online forms so they can be completed in the convenience of your own home or office, before you even arrive to our office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) to 302-777-4002 or bring it with you to your appointment.

New Patient Health History Form – Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print the necessary form(s) form:

New Patient Intake

Download the Free AdobeReader®


Client Experience Questionnaire

We value our patients’ experience at Synergy Integrated Medical Center. If you are currently a patient, please click here to complete the Client Experience Questionnaire.