Patient Forms - Dr. Yah'ki Health & Wellness Detox Inst.

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Operating Hours

Tue - Thu 9:00 AM to 5:30 PM

Dr. Yahki
Dr. Yahki

about us

Your Journey to Natural Health and Wellness Begins Here!

The goal of our Health & Wellness Detox Institute is to provide friendly and compassionate care at the highest level of natural, holistic treatments. With state-of-the-art technology and years of experience, our natural therapies are designed to rejuvenate your body and mind, promoting optimal health and well-being.

  • experienced team
  • comprehensive services
  • state-of-the-art technology
  • Personalized Holistic Care

New Member Intake Form:


This form gathers important information about your medical history, current health status, and personal details to help us understand your needs better.

Credit Card Authorization Form:


This form allows us to securely store your credit card information for payment processing and future transactions related to your care.

HIPAA Form:


This form ensures that you understand your rights regarding the privacy of your health information and gives us permission to share your medical information as needed for your care.

Medical Request Form:


This form is used to request specific medical services or records, helping us assist you in receiving the necessary treatments or information.

Book a Service

Schedule A
Wellness Therapy Session Today!

2402 N Hwy 67, Florissant, Missouri, USA

+1 (314) 455-3372

therapy@yahkihealthclinic.com

Tue - Thur 9:00AM to 5:30PM