4027 Allston Street
Cincinnati, Ohio 45209




Nutrition Forms

Nutrition Forms



The form below must be printed, neatly filled out, and returned to our office by email (doctorsnichols at gmail dot com), faxed to 513-692-9278, or dropped off during our open hours.  It must be scanned in as a document, not pictures, and must be hand printed, type will not save on the form.

Once we receive your form we will call you to schedule your appointment.

Patient registration forms will be filled out in the office when you arrive. You will need to arrive 10 minutes early to fill them out.

We have new patient appointments between 10-12am and at 3pm on Tuesdays and Thursdays, depending on availability. We do not have evening new patient appointments.



We can reschedule initial exam appointments one time with 24 hours notice.  No-Show appointments will not be rescheduled.