In an effort to conserve paper, all of the signatures acknowledging that you have read the forms have been condensed into one page.  Therefore, only the welcome form and the signatures form need to be printed out and brought with you to the visit.  If you would prefer to fill them out at the clinic, please arrive 15 minutes early to do so.

Adults

Please read these forms before your visit:

Email Policy–HB

NOTICE OF PRIVACY PRACTICES HB

Healing Breeze Naturopathic Clinic Policy

Please fill out these forms before your visit:

Intake Forms Signatures HB

Welcome Form

Children/Dependents

Please read these forms for your child or dependent before his/her visit:

Email Policy–Child or Dependent HB

NOTICE OF PRIVACY PRACTICES HB

Healing Breeze Naturopathic Clinic Policy

Please fill out these forms for your child or dependent:

WELCOME FORM–Child or Dependent HB

Intake Forms Signatures HB

 

If you would like to have your records sent from another doctor to Healing Breeze please fill out and sign this form: Medical Records Request Form–to HB

If you would like Healing Breeze send records to another doctor please fill out and sign this form: Medical Records Release Form HB to other