Payment Options
In the office I take cash, checks and gift certificates. If you desire to pay by credit or debit please
pay online in advance. Supplements and remedies are not included in the price online as not everyone gets an Rx.
Payment is expected at the time of service unless prior arrangements have been made.
FORMS
The Health Appraisal Questionnaire.
To make certain your answers are complete, accurate and thoughtful, you will need to set aside some time when you will not be disturbed.
Be assured that there is not a single question on these forms that is not there for a specific reason serving a vital purpose. I understand that filling out these forms is challenging. If you find yourself overwhelmed and unable to complete them, please contact me at 352 365-4325.
For our first meeting or telephone consultation together please bring (or e-mail to me) copies of any recent test results (ask your doctors for copies). If you will be seeing me in the office, please bring any nutritional supplements, herbs, vitamins, or other medications you are currently taking.
If you are having a telephone consultation with me, please send me a recent Polaroid or digital photo of yourself against a plain background. We can also conduct the consultation via
Skype.
I look forward to being a part of your health team.
All information is strictly confidential
Please select the forms I asked you to download. Always print the Consent/HIPPA form and then select the adult or pediatric assessment. If your reason for the consultation is for example headaches or you desire facial rejuvenation also download those forms. If you have digestion issues or desire to work on weight or Autism, please add the food diary. These PDF's have to be downloaded printed and filled out and then brought with you to your appointment or scan them and email them to me.
Thank you for taking the time to fill out the forms. It is important on your journey to wellness.
Autism Health Assessment
Adult Health Assessment
Facial Assessment
Pediatric Health Assessment
Food Diary
Headache Assessment
Consent/HIPPA Form
Stop Smoking Assessment
Menopause Assessment
You will need adobe reader to open the PDF Files
Get directions to
2200 South Bay Street Suite B., Eustis, Fl 32726
MapQuest