New Patients of Patricia Hallam, L.Ac.:
Please print out and fill in the Patient Health History Form and Patient Information & Financial Policy Form ahead of time and bring to your first visit (click on the links below to open and print the files):
Patient Health History Form – Women
Patient Health History Form – Men
Patient Information & Financial Policy Agreement
New Patients of Dr. Daivati Bharadvaj, N.D.:
Please print out and fill in these forms ahead of time and bring to your first visit (click on the link below to open and print the files):
New Patient Intake Forms (pdf version)
New Patient Intake Forms (Word version)
Also, before your first appointment with Dr. Daivati, please fill out your insurance information using the online form below (coming soon). Use “Alive & Well Healing Arts” as the healthcare provider name. And bring your insurance card with you at our first appointment. Thanks!