Thank you for the opportunity to introduce you to Integrative Cannabinoid Medicine! Please follow the steps below to make your intake process as seamless as possible.
Step 1: If this is your first visit with us, download and fill out the Case Review Packet below. Fill out the Release of Information with your personal information, as well as the contact information of your primary care provider or primary care clinic so that we can request and verify your medical records. Grant us permission to fax this form by initialing, signing and dating this form where indicated.
If this is a follow up visit with us, please proceed to Step 2.
Next, fill out the Health History Questionnaire, review the Notice of Privacy Practices, and sign the Release of Liability form.
If you do not have a primary care provider to request records from, please indicate this in the designated field at scheduling.
Step 2: Schedule Your Visitand upload your completed Case Review Packet into the designated field at scheduling. Uploading your packet helps our providers better prepare for your visit. However, if you are unable to download and fill out the Patient Intake forms ahead of time, please arrive to your appointment 15-30 minutes early to fill out any indicated paperwork when you arrive. You can also fax or bring your completed forms with you to your visit.