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New Patient Forms

After an initial introductory conversation to determine suitability, and after setting a date for your first visit, you will be sent an invitation to sign into the electronic health record, Charm Health.

 

After you sign in, you will need to download and fill out the following forms which will be shared with you and available under DOCUMENTS.

 

Please bring them with you filled out to your New Patient Appointment.

New Patient Intake Form

Functional Medicine Treatment Consent Form

HIPAA Privacy Form

Financial Form

Patient Records Request Form

Communications Form