New Patient Information
The following welcome letter will orient you to the clinic and tell you what to expect when you have your first visit. Please read it over before your visit and contact us with any questions.
Welcome Letter (click to open)
5 Steps to Complete Before Your First Visit
These 5 steps (the last 2 are optional) will help you prepare for your first visit. Please set aside some time to complete the required paperwork. Please note: It may take an hour or more to complete this paperwork. This is an extremely important part of preparing for your visit. Having access to the answers to these questions in advance allows the doctor to fully assess your health as a whole and will greatly increase the efficiency of your visit.
If you do not have access to a printer, please contact the clinic and we will happily send you the paperwork in the mail.
IMPORTANT: Be sure to complete Steps 1 and 2 below at least 24 hours before your visit.
1. Print and complete the Intake Form below that applies to the patient
This will allow me to become oriented to your history and your health needs, and it will maximize what can be accomplished in our visit.
Adult Intake Form (click to open)
Pediatric Intake Form -- 0 to 5 years old (click to open)
Pediatric Intake Form -- 6 to 12 years old (click to open)
These intake forms are now available electronically! Please contact the clinic at (360) 378-3355 or DrBronwynBacon@gmail.com for information on how to complete this form online and have it submitted directly to the doctor.
2. Send the completed Intake Form (from Step 1 above) to us at least 24 hours before the visit
Fax, email, mail, or drop it off at the clinic at least 24 hours before your first visit.
- Email: DrBronwynBacon@gmail.com
- Fax: (877) 207-2851
- Mailing address: PO Box 672 / Friday Harbor, WA / 98250
- Physical address: 669 Mullis Street #101 / Friday Harbor, WA / 98250
3. Print and complete the following three forms
Bring all three of these forms to your first visit. If you do not fill them out before your visit, please arrive 30 minutes ahead of time to fill them out.
Consent for Treatment (click to open)
Payment Agreement (click to open)
Privacy Rights (click to open)
4. (Optional) Bring or Request Copies of Medical Records
If you have any labs, diagnostic work, or information from other sources that you would like reviewed during your appointment, please bring them with you. If you do not have copies of this information, please print and fill out the following form and fax or email it to our office. We will use this form to request these records form the appropriate source.
Authorization to Release Confidential Health Information (click to open)
5. (Optional) Bring Completed Insurance Worksheet
I am considered an “out-of-network” provider for all insurance companies. In Washington State, all insurance plans are legally obligated to cover naturopathic care to some degree. Many insurance companies will reimburse their customers for the full or partial cost of a visit with an out-of-network provider.
It is your responsibility to determine your health insurance coverage. Please check with your insurance company to find out your level of coverage for out-of-network naturopathic care. To assist you in this process, we have created this insurance worksheet:
Insurance Worksheet (click to open)
If you plan to seek reimbursement from your insurance company for your visits, please complete this form and bring it to your visit. We will provide you with a superbill, which you can submit to your insurance company to request reimbursement.
What to bring to your appointment
- New patient paperwork
- Any medications or supplements you are currently taking
- Medical records as detailed above (if applicable)
-
Insurance worksheet (if applicable)
What to expect from your first visit
A first office visit lasts about 60 minutes.
This visit includes a detailed medical history of your current health concerns, a pertinent physical exam, assessment of current health complaints, and laboratory work if indicated. I will then create a tailored treatment plan to fit your needs. In some cases, specific treatment options will not be decided on until the results of laboratory or diagnostic tests have been received and reviewed.
Usually a follow-up visit will be scheduled to assess how treatment is going and to determine if any changes need to be made to this plan. It is typically ideal to schedule this follow-up appointment within 2-3 weeks of your first office visit. However the length between visits will depend on your specific health concerns and treatment.
Follow up visits last about 30 minutes.
Privacy Practices (HIPAA)
The following paperwork explains our privacy practices. There is no need for you to print out these forms as they will be provided to you at your first visit. They are included here in case you ever need to reference them online.
Notice of Privacy Practices (click to open)
Acknowledgment of Receipt of Notice of Privacy Practices (click to open)
