11075 South State Street Bldg. #31
Sandy, Utah 84070
Appointment scheduled Wednesday _________________________at ___________o’clock
48-HOUR CANCELLATION NOTICE IS REQUIRED
Please read our Welcome Letter carefully and sign at the bottom
Congratulations in taking this first and perhaps most important step towards improving your health. Your Core Diagnostics, as performed by Vitál Medical Spa practitioners is an integrative,
personalized, and comprehensive health assessment. Your exam will identify key health
information and indicators as to what preventive measures and lifestyle program is best designed
to reclaim, revitalize, and maintain your health. Enclosed is important paperwork that will start
you on your way to wellness.
Please give yourself plenty of time to fill out the enclosed information
Please fill all forms out as completely as possible.
Leave questions blank if you are uncertain of your answers.
Send information certified mail this information to us prior to your first appointment.
All information MUST BE COMPLETED in its entirety before you can be seen for the
What to Expect
The Core Diagnostics (including labs) will take approximately four to six hours to complete, with
ample time provided for discussion of health, history and symptomatology. Our team of
practitioners will individually evaluate your current state-of-health using five departments of
medicine as well as a therapeutic spa:
Preventive Medicine Energetic Medicine
Functional Medicine Lifestyle Medicine
Spiritual Medicine Therapeutic Spa
As with anything in life, it is better to prevent a problem than try to correct it. Preventive
Medicine incorporates objective testing including vital signs and blood labs as well as clinical
diagnostics to identify existing and underlying health problems. Diagnostics and prevention will
be emphasized on the major health concerns in our society: Heart disease, high blood pressure
and cholesterol, diabetes, stroke, cancer, osteoporosis, Alzheimer’s, metabolic syndrome, and
immune dysfunction. This session will take approximately 1 hour.
Functional Medicine is a science-based, natural approach that looks at the whole person, and
more importantly, the underlying causes of an illness, rather that the disease itself to identify and
determine treatment strategies. This comprehensive health appraisal evaluation using Clinical-
Kinesiology includes spine and joint function, nerve dysfunction, depression, allergies,
circulatory problems, organ and gland function, body pathogens, toxicities, digestive disorders,
hormones, vitamin and mineral deficiencies and more. This session will take approximately 1
Your emotional and mental well-being is intertwined with your physical health, and is a widely
recognized component to overall health. Spiritual Medicine will support you in developing the
tools needed for change and the ability to move forward optimizing the quality of your life and
over-all health. This session will take approximately 1 hour.
Energetic Medicine describes the growing number of approaches where an understanding of the
body as a system of energies is applied for promoting health, healing, and homeostasis. Leading
this field is Acupuncture and Traditional Chinese Medicine. Through the eyes of Eastern
Medicine, this exam incorporates pulse and tongue diagnosis; a powerful adjunct in the field of
Alternative Medicine. This assessment takes approximately 1 hour.
A conscious lifestyle means living your life in a proactive way that consistently improves your
health. Lifestyle Medicine helps educate and motivate you in your daily quest for optimal health
and ideal body composition through a combination of balanced eating, regular exercise, reduction
of stress, and using correct supplements. This assessment takes approximately 1 hour.
If the medicine departments aren’t enough, Vitáls skin care practitioners’ will thoroughly
examine your skin including an analysis and detection of hyper-pigmentation, dryness, premature aging, sun damaged areas and more. You’ll be looking as good on the outside as you’ll be feeling on the inside.
CORE DIAGNOSTICS INSTRUCTIONS ? Bring in all additional completed paperwork ? Bring a list a vitamin supplements and pharmaceuticals you are taking; if possible bring in the bottle(s). ? Drink 2-3 glasses of water prior to your visit ? Bring a snack or meal if needed
? Continue taking prescription medication(s).
? Bring in your urine specimen (follow the directions prior to test)
? Come to your appointment fasting (no food or drinks, other than water after
If you have any additional questions regarding the Core Diagnostics, please contact our
Program Coordinator 801.858.3733.
Patient Acknowledgement Signature Required Today’s Date