REQUIREMENTS

Note: you may email this page to yourself so you can access the following again.

1. Please download all 3 applicable files, fill out, and email back to us at appliednaturalhealth@gmail.com no less than 2 days before your event.

Pediatric

Arbitration and Consent to Treat

Pediatric Intake Form

Pediatric Photo Consent Form

Adults

Arbitration and Consent to Treat

Exam Form

Photo Consent Form

2. Google Drive Folder with your name/child’s name — we need 5 days worth of adults and children’s meals photos, following the guidelines below:

  • Ingredients and pot/pan while you’re cooking, and plated food

  • Ingredients list of packaged goods (milk, baby formula, broths, juice pouches, snacks, etc)

  • Your pots and pans

  • Plates, bowls, utensils, food storage, chopping board, mixing bowls, etc

Save all photos to your Google Drive folder with your name/child’s name

  • Include clear photos of current skin condition

  • Include one photo of yourself/yourself and your child for profile picture (a close up photo is best)

We will ask you to reschedule if you do not have 5 days worth of meals’ photos.

Do not create slides or attach photos to documents.

Do not crop your photos.

Do not use images from search engines.

3. After we are notified of your completed booking, our HIPAA compliant patient portal, Unified Practice, will send an email to you to create your/your child’s profile in our system. Address is required whether you are in-person or virtual—please be sure your address and phone number are entered correctly.

We are not responsible for failed deliveries if you entered your address incorrectly in Unified Practice.