NEW PATIENT INTAKE FORMS
Dr. Mischa Grieder, ND
Welcome to the office of Dr. Mischa Greider, N.D. at San Francisco Preventive Medical Group! The New Patient Package linked below contains our office policies and procedures, and a comprehensive intake form. The following checklist will help you navigate The Package. Please email or fax all 5 documents back to the office filled out at least 7 days before your New Patient appointment with Dr. Grieder. Feel free to include any lab reports or other documents that you would want him to see.
Please fill out the Patient Information form, and read the 4 page welcome letter that highlights the office policies and procedures for appointments and labs, financial information, and pricing. Please be sure to sign on page 3.
Dr. Grieder Intake Form: Patient Information
Dr. Grieder Welcomes You!
Fill out the comprehensive medical history form and physician contact form. Be sure to return it to our office at least 7 days prior to your appointment. Included are a symptom bubble sheet and a medication list. You are welcome to fill these out in advance and bring them to your appointment.
Dr. Grieder Intake Form: Patient Health History
Dr. Grieder Intake Form: Physician Contact
Patients with Lyme Disease are to sign and return the following consent form.
Dr. Grieder Intake Form: Lyme Disease
Lastly, when you arrive at our office, you will be enrolled in Elation’s Patient Passport. Elation is the Electronic Medical Record (EMR) software that our office uses, and the Passport is the preferred method of contact for the office. You can use it to request appointments, order supplements, keep us updated of any symptoms, and directly contact Dr. Grieder.
REMEMBER; IF YOU ARE EXPERIENCING A MEDICAL EMERGENCY PLEASE GO TO THE EMERGENCY ROOM OR CALL 911.
We look forward to meeting you!
