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Patient Forms

For New Patients

Step Two- Print and Fill out the Forms Below:

  • Informed Consent
  • Primary Care Policy
  • Services not Covered by Insurance
  • HIPAA Notice of Privacy Practices
  • Demographics
  • Patient Medical History
  • Finding Your Prakruti

Step One- Read Each Link Below:

  • Informed Consent
  • Primary Care Policy
  • Services not Covered by Insurance
  • HIPAA Notice of Privacy Practices
  • Demographics
  • Patient Medical History
  • Finding Your Prakruti
  • Privacy Policy Statement
  • Security Policy Statement

For Existing Patients

Please log in to your secure Patient Portal at http://my.patientfusion.com
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