Clinic Forms

  Intake Form 18  New Patients: Please print, fill out, and bring this and the following two forms to your first visit to speed up the intake process. (PDF, Adobe Reader required)

HIPAAConsent18 HIPAA Consent Form

GalenMDF2018 Mandatory Disclosure Form

This is the HIPAA Notice of Patient Privacy that the HIPAA Consent Form, above, references.

TRWNoticeofPtPrivacy Patient Privacy Notice

Links

Here is the Amazon link to my frequently recommended book, Pain Free, by Pete Egoscue. Natural Grocers usually has it in stock as well.

https://www.amazon.com/Pain-Free-Revolutionary-Stopping-Chronic/dp/0553379887/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=1490118211&sr=8-1

Clinic Forms was last modified: November 29th, 2018 by admin