New Patients
Have you scheduled a new patient visit? Please see complete the intake forms below, we will send you them by email as well. Please email or fax them securely, including a copy of your insurance card at least 3 days before your scheduled appointment. A 24 hour notice of cancellation is required for all appointments.
We contract with Regence, Premera, Lifewise, and First Choice Healthcare, Bridgespan, we are out of network providers for all other insurance companies so please check the terms of your insurance beforehand. We are not contracted providers with Aetna, Cigna or Group Health.
Please download the following intake forms and scan/email or securely fax them to us: 1-888-972-6908
Once intake forms are received an email invitation to CharmPHR portal will be sent to you for HIPAA compliant communication. For first office visits by telemed, a zoom link will also be sent.
Please note all new NAET patients must first schedule a free meet and greet before scheduling an allergy treatment.
Intake Forms
- Patient Intake Form: GNM Patient Intake Form
- Consent Form and Insurance Information: GNM Financial Consent & Agreement
- Braverman’s Neurotransmitter 2-Part Questionnaire: Braverman Neurotransmitter Questionnaire
- Nutritional Assessment Questionnaire: GNM Nutritional Assessment
- What do you want to achieve health-wise? This health survey might help you figure out your health goals. Then fill out the Positive Outcomes Worksheet.
- Authorization to Release Confidential Health Information: Authorization to Release Medical Records
- About Good Natured Medicine Practices and Policies, Insurance Networks: GNM Info for New Patients
Optional Forms
- Email Communications Consent: Email Opt-In
- Notice of Privacy Practices: Privacy Notice