Testimonial

Before my first visit, Carol gave me a health questionnaire to complete. At my first visit, we discussed the questionnaire, my physical and emotional health and my desires from any treatments.  Carol is a caring person with a very holistic, realistic and educated approach. CM

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Clinic Forms

This is the list of various forms that you may want to download and fill out before you come into the clinic. They are grouped so they best serve your desired treatment. All forms are linked in Acrobat PDF format.

Acupuncture

Patient Rights and Responsibilities – must read, do not need to print out, keep for reference
Consent for Acupuncture
HIPPA Office consent
Health History
Pediatric Health History – if this applies
Cash or Insurance payment agreement
Please check with your insurance company as to your coverage. Read both forms so there are no
surprises.

NAET Treatments

Patient Rights and Responsibilities – must read, do not need to print out, keep for reference
Instructions to new NAET patient
NAET treatment consent
HIPPA Office consent
NAET Allergy rating scale
Health History
Pediatric Health History – if this applies
NAET financial agreement

Counseling

Please discuss this directly with Jennifer Krumm, LPC