New Patient Intake:
These Intake Forms Are Essential To Your Care Plan
In order for Dr.
Myatt to have as much information as possible with which to research your
case and plan your care, we have a packet of information forms that all new
patients must complete:
These Forms Are:
Patient information
-
This form explains your relationship with Dr.
Myatt, and how you will work together towards your best health ever.
Authorization to Release Medical Records
- This form, signed and given to your other
health care providers will allow them to send your medical records to Dr.
Myatt for her study and analysis.
Patient Registration - This
form sounds simple, but here you will provide a great deal of information
about yourself, your health, and what you wish to achieve as you work
together with Dr. Myatt.
Comprehensive Health
Appraisal - This 9 page health
questionnaire and symptom survey will make you think hard. By completing it
fully and honestly, you will provide Dr. Myatt with valuable insights to
your body systems and clues to help her in her investigations as she
develops your personalized Health Action Plan.
We suggest that you open
these pages by clicking on the links above, and then print them out. You may
then complete them and then fax or mail them back to us. If you fax your
forms to save time, please also mail us the originals!
Our Fax:
1-(928)-536-5691
Our Mail:
Dr. Myatt’s Wellness Club
P.O. Box 900
Snowflake
Arizona 85937
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