Forms and Publications
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:
- Print the paper version: Download the form, print it, and fill it out.
- 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.
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 or want to make an appointment? Please send me a note with your question, and I'll get back to you asap! Thanks!