Functional Medicine with
Dr. Thomas Rohde

Please complete the following patient registration forms if you wish to be seen for a functional medicine evaluation, including thyroid, hormones, regenerative medicine including joint pain, stem cell therapy, etc. 

This process should take you about 30 minutes.

Traditional Family Medicine, Injectables, and
Vasectomy Procedures

Please complete the following patient registration forms if you wish to be seen for traditional/family medicine, cosmetic procedures, including Botox, fillers, etc., or our No-Scalpel Vasectomy.

This process should take you about 15 minutes. 

Functional Medicine
Traditional Medicine

If you prefer paper and pen, you can download our new patient packet using the link below. Completed forms should be returned to our office as soon as possible. 

Download New Patient Forms

For patients transferring care OUT to another doctor, please print the form below and return the completed document to our office.
Download Transfer of Care Form

 

LOCATION
  • Renew Total Body Wellness Center
  • 3798 E. Fulton Avenue
  • Decatur, IL 62521
  • Phone: 217-864-2700
  • Fax: 217-422-0004
OFFICE HOURS
  • Monday 8:00 am - 5:30 pm
  • Tuesday 8:00 am - 5:30 pm
  • Wednesday 8:00 am - 5:30 pm
  • Thursday 8:00 am - 5:30 pm
  • Friday 8:00 am - 12:00 pm
  • Saturday Closed
  • Sunday Closed
GET IN TOUCH
217-864-2700