Patient Forms

A (Before your 1st appointment) – Click here to download all 5 forms together
Bring these with you to your first appointment.

The 5 Individual New Patient Forms

  •  Find the Cause of Your Weight Problem—Body Shape Quiz
  •  Weight Loss Difficulty Questionnaire
  •  Most Commonly Reactive Foods
  •  Body Mass Index
  •  Metabolic Assessment Form (MAF)—complete sections VI & VII only

Weeks 1–8: Complete Program

B (Complete 8-Week Program) – Click here to download 1 single pdf
Individual pdfs for 8-Week Program

Week 1

  •  Stapling Instructions for pdfs
  •  Diet Diary (make 8 copies)
  •  Hunger Is All in Your Head
  •  Neurotransmitter Assessment Form (NTAF)
  •  Glycemic Index
  •  Blood Test Instructions
  •  Insulin Resistance Evaluation

Week 2

  •  Eight Physical Causes of Weight Problems
  •  Liver Enhancement Program

Week 3

  •  QRA Nutrition Testing Chart (don’t fill out)
  •  First Time Evaluation
  •  Balancing pH

Week 4

  •  Metabolic Type I
  •  The Blood Sugar Diet

Week 5

  •  Metabolic Type II

Week 6

  •  Metabolic Type III—Chinese 5 Elements Questionnaire
  •  Chinese Five Elements Diet

Week 7

  •  Metabolic Type IV—Ayurvedic Body Type Evaluation
  •  Ayurvedic Diet

Week 8

  •  Eat and Avoid List

Special Diets

  • SD_A-O
  • SD_TL
  • Dr. Stone’s Purifying Diet
  • Changes that Occur During the Purifying Diet

Contact Us

Send Us An Email Today!

Our Location

Find us on the map

Office Hours

Find Out When We Are Open



9:00 am-5:00 pm


9:00 am-5:00 pm


9:00 am-5:00 pm


9:00 am-5:00 pm


9:00 am-5:00 pm