Reno Integrative Health and Wellness
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  • Cancer Boot Camp
  • Primary Care
  • Weight Loss
  • Wellness
  • Detox
  • Chiropractic Care
Patients
  • Patient Portal
  • Forms
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Contact Us
Reno Integrative Health and Wellness
Home
Services
  • Cancer Boot Camp
  • Primary Care
  • Weight Loss
  • Wellness
  • Detox
  • Chiropractic Care
Patients
  • Patient Portal
  • Forms
  • Important Links
Contact Us
More
  • Home
  • Services
    • Cancer Boot Camp
    • Primary Care
    • Weight Loss
    • Wellness
    • Detox
    • Chiropractic Care
  • Patients
    • Patient Portal
    • Forms
    • Important Links
  • Contact Us
  • Home
  • Services
    • Cancer Boot Camp
    • Primary Care
    • Weight Loss
    • Wellness
    • Detox
    • Chiropractic Care
  • Patients
    • Patient Portal
    • Forms
    • Important Links
  • Contact Us

ForM Downloads

1. Personal Information (xls)Download
2. Health History page 1 (xlsx)Download
3. Health History document page 2 (xlsx)Download
4. & 5 HIPAA Release of information - April 2018 (docx)Download
6 & 7 Agreement Scope of Practice (docx)Download
8. Insurance Billing (docx)Download
9. Payment Agreement (doc)Download
10. Statement of Intent (docx)Download
11. Treatment & Arbitration Agreement (doc)Download
12. Privacy Notice Acknowledgement (doc)Download
Consent for Treatment 01.05.23 (docx)Download

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