Body Anew Acupuncture
Traditional Chinese Medicine for Health and Wellbeing
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Patient Paperwork
 

 

 

New Patient Welcome Letter:

 

May 10, 2007

Dear New Patient,

Welcome! Thank you so much for your interest in acupuncture and Oriental medicine. At Body Anew we do our best in every way possible to assure that you receive the best quality care. We want you to know we at Body Anew are dedicated to:

 

  • Make sure that our customer service always meets the highest standards.
  • Make sure that any questions you have about your care are answered in a way that you can understand.
  • Make sure that your phone calls are returned promptly.
  • Make sure that your private health care information is kept secure and private.

 

On this page, you will find several forms that we’d like you to fill out and bring with you to your first appointment. If you have any questions about these forms, please call us at 443-414-4005 and we will be happy to help you.

Again, welcome to Body Anew. You have taken an important step on the road to more vibrant health. We look forward to serving you.

     Yours sincerely,

     T. Justin Landers,

     L.Ac., Dipl. O.M. (NCCAOM), M.A.O.M.

 

 
For your convenience, the documents are provided in two different formats.  They are saved in .PDF files for those of you with Adobe Acrobat Reader, but they are also saved as .DOC files for those of you with Microsoft Office.  Get Adobe Acrobat Reader free here.
 
Health History Questionnaire 
The most time-consuming, but most helpful document you can bring with you is the record of your health history.
 
Privacy Policy Notification
This is a letter from Mr. Landers to his patients advising them of their right to proctect their privacy.
 
Privacy Policy
This is a bit of paperwork that shows you understand your right to protect your personal health information (PHI).  It will need your signature either before you go to the office or once you get there.
 
Consent for Treatment Form
This page informs the patient of the risks of getting a Traditional Chinese Medicine treatment.  But if you have questions about the kinds of side effects you may see in TCM, check here.
 
One other way you can help is to go to your physician or specialist and sign a release for some of your medical information.  Labs, x-rays, CT films, etc. may all be very helpful for Mr. Landers.  You can use our Medical Records Release Form (.PDF or .DOC).  It is important that you fill this form out and get it to your doctor/specialist so that they can release the information requested in a timely fashion.  Some doctors/specialists charge a small fee for copying information, so be sure to inquire about this.  All medical records release requests must be signed by a person 18 years or older, or by a legal guardian.  Thank you for your cooperation.
 
We at Body Anew know that you are probably very busy and we respect that.  If you don't have time to print out all of these pages, you may be wondering what is essential and what is not.  Definitely bring the Health History Questionnaire to your first appointment.  By filling this out early, you cut down on time spent reading paperwork, giving us at Body Anew a chance to spend more time with you as a patient.  If you can, bring a signed copy of both the Privacy Policy and the Consent to Treatment forms.  While not essential, these forms still need to be read and signed before your treatment.  Getting them out of the way can help speed things up.