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 Form
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 – 2021 (PDF version)
New Patient Intake forms – 2021 (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!