Downloadable Forms for New Patients  

 

 

 

Required paperwork for new patients is extensive.  I highly recommend downloading all 5 of the forms below and completing them before arriving for your first visit. 

1) New Patient Information and Health History

*The form above is very long. If you decide to print this as a double sided document to save paper PLEASE print the back side (even numbered pages) UPSIDE DOWN. (this makes it much easier to read once it is in your chart).

2) Insurance Information

3) Clinic Policies

4) Privacy Policies

5) Consent for Treatment

If you are coming in to address issues of fatigue, chronic aches and pains, mental fog, menstrual issues, headaches, or thyroid issues, please also consider downloading and completing this temperature log before your first visit.

Temperature Log

As a naturopathic physician, acupuncturist, and massage therapist (multi-credentialed provider), I am a bit of an insurance anomaly.  In addition every insurance policy is unique in it's benefit details and limitations.  Many patients find it both helpful and educational to clarify thier insurance coverage using our Insurance Information form as a guideline for asking clarifying questions about their policy. 

Please note:  we do not confirm insurance coverage or benefit details for our patients.  Please clarify your coverage with your provider and indicate details on the insurance form before arriving for your first visit.