Forms and Publications

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Getting Started Guide

This guide will give you all the information about me and what I do. It will also help you decide whether we would be a good fit to work together.

Health Information Form

This form will give Pickled Beet all the information needed to begin assisting you on the path to good health. It is a required document.

There are two ways to do this:

  1. Print the paper version:  Download the form, print it, and fill it out.
  2. Use the computer version: Download the form, open it in Adobe Acrobat Reader, type in your information, save it, and then print it out OR email it to me.

Once you’ve completed the form, please contact me for the next steps.

Get the paper version ›

Get the computer version ›

 

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Consent Form

A document that explains the risks that you (the client) assume when partaking in service(s) and/or a wellness program with Pickled Beet. It is important for you to read and understand the risks completely.

Download the Consent Form ›

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Notice of Privacy Practices Documents

Please review both of these documents carefully.

Notice of Privacy Practices Form

This notice describes how medical information about you may be used and disclosed, and how you can get access to this information. This form complies with HIPPA.

Download the Notice of Privacy Practices Form ›

Acknowledgment of Receipt of Notice of Privacy Practices Form

This second form is the official acknowledgment of receipt of the Notice of Privacy Practices form. It is a verification that the client received that form and complies with HIPPA.

Download the Acknowledgement of Receipt of Notice of Privacy Practices Form ›

Get in touch

Have a question? Please send me a note with your question, and I'll get back to you asap! Thanks!

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“Let food be thy medicine and medicine be thy food.” ~ Hippocrates