SOUTH BAY TOTAL HEALTH
Health Care in Harmony with Nature
Dr. Arlan Cage, ND, LAc


 

NEW PATIENT FORMS
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All forms are downloadable pdf's. You will need Adobe Acrobat Reader to view and print them.

We must receive those forms identified as "Fill Out and Return" BEFORE your first appointment will be scheduled.

Faxing them in is the fastest method of returning them to us. If you don't have access to a fax machine, use standard mail or drop them off at the office.

You Need All of the Forms in This Group:
HIPPA Privacy Policy
HIPPA Consent
Receipt of Privacy Policy
Financial Policy
Patient Information and Data Sheet
Print out and Keep
Fill out and Return
Fill out and Return
Fill out and Return, Keep a copy
Fill out and Return

Use One Form in This Group as Appropriate:
Female Health History
Male Health History
Pediatric Health History
Fill out and Return
Fill out and Return
Fill out and Return



2204 Torrance Blvd. Suite 104, Torrance, CA 90501      Ph: (310) 803-8803      Fax: (310) 803-8805      info@southbaytotalhealth.com