New Patient Forms

If you are coming to our clinic for the first time, you can download and complete our forms at home to save time at your first visit.

If you’d rather fill them out when you get to our office, please arrive 20 minutes early, and bring a complete list of your medications (with the condition for which they are prescribed, the dosage and frequency) and nutritional supplements.

I look forward to serving you!

Initial Patient Forms

There are some forms that need to be filled out before you get to see the doctor. You have a couple of choices:

  • Download them from here and print them.  You can fill them out beforehand and show up for your appointment on time.

Or:

  • Bring a complete list of your medication/vitamins and come to your initial visit about 20 minutes early so you can fill them out in our office.

New Chiropractic Patient Intake: Anyone who is primarily interested in Chiropractic care gets to fill this one out.

New Total Wellness Patient Intake: Anyone who wants to take advantage of the Wellness services offered need to fill out this longer Intake.

NRCT Authorization Form: Please fill out this form if you want the Doctor to perform the free test to see if Neurologic Relief Center Technique will help you.

Existing Patient Update:If you have been to see Dr. Joan before but it’s been over a year since your last visit you will need this form.

Notice Of Privacy Practice:   HIPAA requires that you be given a printed copy of this form if you so desire.  There is a signature required on the last page.

Patient Privacy

As a patient of Global Wellness you will have certain privacy expectations. Global Wellness is fully compliant with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy and security rules for health care providers. The confidentiality of your patient records is of paramount concern.

You can read about how I comply with HIPAA rules here.  You can read our privacy policy here. You can download a copy of our privacy policy by clicking the link below. I will give you a copy, if you’d like, on your first visit, and will ask you to sign a form indicating that you understand this policy.

Your Rights and Responsibilities

In addition, you have certain rights and responsibilities as a patient in our clinics. You have the right to expect excellent clinical care and to have all of your treatment explained to you and every question answered to your satisfaction. Want to know more? Review detailed information in the document below or call if you have more questions.