3 Pillars Therapeutics

  • 959-900-8855
  • 860-785-6590

To access any of the forms below, please click the button for the form and wait for Adobe Reader to launch and load.


Once the form has loaded, please print it, complete it, then return it to Clinical Paradigms, LLC.

Patient Registration Form (complete this first)

Patient Registration Form

Patient Intake Form (26 pages)

Intake Questionnaire

Allergy History

Allergy History

Medication List

Medication List

Three-Day Food Log

Food Log