Testing Page My Courses Login Email Address* Password* Login Remember me Lost your password? New Patient Information New Patient Information EVOLUTIONARY HEALING INSTITUTE 6601 SW 80 Street, Suite 200A, South Miami, Florida, 33143 ph: 305.667.8174 www.ehmiami.com Date Name Name First First Last Last Phone Email Street Address City State Zip Code Gender Age Date of Birth Minor? No Yes Marital Status Single Married Widowed Separated Divorced Partnered Indicate where you continue to have pain, numbing or tingling and rate below the severity of your pain according to where 1 is least pain and 10 is severe pain. If you are human, leave this field blank. Submit