Dr. Nicole Fenske
 608.836.8883

 Fenske Holistic Healthcare Ctr
 7600 Terrace Ave., #102
 Middleton, WI 53562
 608.836.8863 (fax) 
 mailto:FenskeDC@aol.com

Learn about the latest research in natural healthcare.

 

>>Select a topicAcneADD/ADHDAgingAllergiesAlzheimer's DiseaseAntioxidantsArthritisAsthma and other Lung IssuesAutismAutoimmune DiseaseBack and neck painBlood pressureBowel floraCancerCardiovascularChildren's HealthDentistryDepression and AnxietyDiabetesDiet and lifestyleDigestionDrugsEssential fatty acidsExerciseEyeFatigueFibromyalgiaHeadachesHerbsHypoglycemiaImmune systemKidneyMale Health IssuesManual TherapyMenopauseMental healthNaturopathyNeurological conditionsOsteoporosisPain and inflammationPMSPregnancySinusesSkinSmokingSports InjuriesSports PerformanceStressSurgeryThyroidVitamins and mineralsWeight LossWomen's health issues

Sign up to receive our newsletter

 Welcome New Patients

(see below for intake forms)

Welcome to Fenske Holistic Healthcare Center!  We appreciate the trust you have placed in us to work together with you to regain and maintain your health.  We pride ourselves in our commitment to our patients.  We look after each patient as we would the closest member of our family.

Please download and complete the appropriate forms below (based on whether you have an initial appointment for Chiropractic care or Functional Medicine care).  Chiropractic patients please bring the completed paperwork to your initial appointment.  Functional Medicine patients please send us your completed paperwork prior to your appointment.  Although completing the paperwork will take time, the more I know about you the better I will be able to assist you.

We look forward to a long and positive relationship with you.  Please consider us your family holistic healthcare office and do not hesitate to ask us how we can be of help in any and all circumstances regarding your health and the health of your family.

Dr. Nicole Fenske

 

Forms for Chiropractic care:

1. CHIROPRACTIC PATIENT INFORMATION (1 pg)

2. PATIENT HEALTH HISTORY (7 pg)

Children under 7 years old substitute this form for the Chiropractic Health History form above.  For infants fill out as much as applies.

    PATIENT HEALTH HISTORY (CHILDREN UNDER 7) (2 pg)

 

Forms for Functional Medicine care:

1. PATIENT ACCEPTANCE POLICY (2 pg)

2. PATIENT HEALTH HISTORY (7 pg)

3. NUTRITIONAL ASSESSMENT QUESTIONNAIRE (4 pg)

4. DIET & LIFESTYLE DIARY (2 pg)

5. HEALTH GOALS (2 pg)

6. REQUEST FOR RECORDS (1 pg) (use 1 for each request)

 

Children under 7 years old substitute this form for the Patient Health History form above, but complete all remaining Functional Medicine forms above.  For infants fill out as much as applies.

    PATIENT HEALTH HISTORY (CHILDREN UNDER 7) (2 pg)

 

After your second office visit you will typically be given a Progress Questionnaire to complete prior to your third visit.  Below is the questionnaire if you need an extra copy.

    PROGRESS QUESTIONNAIRE (2 pg)