Free templates & resources for functional medicine practices
Download ready-to-use templates built for functional medicine practices. Each template is designed to save you time — use them as-is or customize them to fit your workflow.
Practice Templates
Free resources to streamline your patient intake and assessment process.
New Patient Intake Form
A complete functional medicine new patient health intake form template. Includes basic information, chief complaint, symptom checklist by body system, lifestyle and diet, medical history, and previous testing sections.
Quiz Question Templates
Four sets of ready-to-copy assessment quiz question templates for Gut Health, Hormone Health, Thyroid Health, and Fatigue & Energy. Each set maps responses to clinical archetypes.
Guides for Patients
Free plain-language guides your patients can use to prepare for appointments — share them directly.
PCOS Labs Checklist
The complete PCOS workup explained in plain language — hormone & androgen panel, metabolic labs, and rule-out tests, plus why normal labs don't rule PCOS out.
PCOS Pattern Quiz
A free 3-minute quiz that maps symptoms to one of four PCOS patterns — insulin-resistant, inflammatory, adrenal-stress, or post-pill — with a personalized report by email. A screening signal, not a diagnosis.
TyG Index Calculator
A free insulin resistance signal from two routine fasting labs — triglycerides and glucose. Instant results with reference ranges and plain-language interpretation.
Frequently asked questions
Are these templates really free?
Yes. All templates on this page are free to download, print, and use in your practice. No sign-up required for the downloadable versions.
Can I customize these templates for my practice?
Absolutely. Every template is designed to be a starting point. You can modify, add, or remove sections to match your clinical approach and patient population.
How is the intake form different from a standard medical form?
A functional medicine intake form goes deeper than a standard medical history form. It covers diet, lifestyle, stress, environmental exposures, and system-by-system symptom review — the data points functional medicine practitioners need for root-cause analysis.
What if I want to automate this instead of using paper forms?
Brevlix turns these templates into interactive online assessments that patients complete on your website. Responses are scored automatically, mapped to clinical archetypes, and delivered as structured reports — no manual data entry.
Brevlix Automates This
Entire Process.
Instead of printing, emailing, and manually reviewing intake forms, Brevlix collects patient responses online and delivers structured clinical reports automatically.
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