Patient Information – Your Labwork
Good Health | It’s a Matter of Fact.
Welcome to Integrative Health. Here, we gather the facts necessary to treat the root cause of your symptoms, identify early risks then empower you with the information you need to claim a positive and active role in your health.
We look forward to getting to know you. Here is some information to help you prepare for your initial appointment:
- To keep the clinic running ‘on time’ throughout the day, we carefully schedule appointments; therefore late cancellations or missed appointments with the doctors will be billed for the full cost of the visit. Late cancellations or missed appointments for a shot or IV will be billed a fee of $50 – $100 depending on the treatment cost. If you need to cancel or reschedule, please do so by calling at last 48 hours prior to your appointment. If you arrive 9 minutes late, please be prepared to reschedule and pay the appropriate fee.
- As we are a ‘fee-for-service’ office and are not contracted with any insurance companies, we require payment to be made at the time of service or prior to service. You are 100% responsible for all fees. Cash, checks and major credit cards are accepted.
- I understand that any expenses incurred with Integrative Health (Integrative Health or IH) for myself or any of my minor dependents are my responsibility and not that of any other person or insurance group.
- I understand that payment is due in full at the time of service.
- I understand that I will be billed for any appointment missed or changed with less than two-business days’ notice.
- I understand that no claims or guarantees have been made by Integrative Health personnel for future insurance reimbursement or particular medical outcomes.
- I understand that not all treatments or products used by Integrative Health are FDA approved.
- I understand there are times a phone consultation with the doctor may be necessary and that such a consultation are placed on the doctor’s schedule and billed as a regular appointment.
- I understand that all information given to Integrative Health now or at any point in the future is entirely confidential.
- It is Integrative Health’s policy to follow HIPAA guidelines and IH requires a signed medical release form before releasing medical records to anyone other than myself unless legally required to do so. I may choose to keep a release form on file to expedite the handling of my records.
- At times, e-mail or fax may be the best option to communicate confidential medical information between myself and my doctor.
- My signature below gives Integrative Health permission to fax or email medical records to myself at a fax number or email address given to Integrative Health by myself. I understand these are not secure forms of communication and my records will not be protected when using these forms of communication.
- I will tell my doctor about any medication I am currently taking so that drug/herb/supplement interactions are minimized.
Potential side effects of any herb/supplement recommended to you will be discussed by your doctor.