Office Policies & Procedures

Office Hours

Our office is open Monday – Friday from 8:30am – 5:00pm and can be reached at 415-566-1000. We are closed for major holidays and during the week between Christmas and New Year. If you need an appointment, prescription refill or test results, please call or message us during regular business hours.

Patient Portal

Elation is the Electronic Medical Record (EMR) software utilized by our office. The Passport is our 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 your provider. If you are unsure whether you are enrolled, please check in at the front desk. You will need to provide your email address in order to enroll.


We strive to return patient calls or portal messages as soon as possible. Non-urgent calls and messages will be returned within 48 business hours. Please call our office directly for any urgent issues and go to the nearest ER or call 911 for emergencies and/or life-threatening issues.


We realize that many of our patients are not local to San Francisco and travel from a distance to visit Dr. Grieder and his associates. In order to properly care for you, we require that you come to our office for follow-up visits and regular consultation. Patients should plan to be seen every 4-8 weeks, depending on the complexity of their illness. Phone consultations are available for in between appointments but are not meant to replace in-office follow up visits. For those patients who live outside of the state of California, please note that your first visit will need to be in-person and you will be required to complete an in-person visit once every 3 months. If you need assistance in between your in-person visits, your provider can communicate with you and provide visits via phone or zoom. Please take the travel requirement into your decision to visit us at San Francisco Preventive Medical Group. At the time of your initial visit, a follow-up visit will also be scheduled to discuss our findings.

New Patients

We accept new patients from either physician referral or self-referral. As a patient of Dr. Grieder and his associates, we strongly recommend that your Primary Care Physician be informed of our evaluation and treatment plans. This is not to say that your doctor must agree with our theories; however, the physicians to whom you entrust your health need full disclosure of any medications and/or supplements that could possibly interact with other prescriptions.

Your Initial Appointment

In order for your appointment to be efficient and productive, you must have all forms in this packet completed and sent into our office at least 7 days prior to your arrival at the office. Should you have any questions on the packet, please contact our office at 415-566-1000. On the day of your appointment, please arrive at the clinic 15 minutes prior to your scheduled appointment time.

At your initial appointment, your provider will do the following:

  • Review your admission packet
  • Obtain a thorough history
  • Review any previous lab testing
  • Perform a physical assessment
  • Answer questions about our practice
  • We will also recommend any pertinent testing, discuss treatment options, and recommend a treatment schedule if indicated. Please plan to spend up to two hours at this visit.
  • *It is highly recommended that a family member, partner, close friend, or advocate accompany the patient to their initial evaluation. This is to ensure a most successful and productive appointment.
  • About Laboratory Testing

  • Following this encounter, you may have blood drawn for lab tests. Some labs, such as those performed by Quest or Labcorp may be covered by your insurance. Please make sure that your insurance information is presented to the laboratory technicians when services are rendered. Additionally, we may use specialty labs (including IGeneX) that do not accept insurance assignments; therefore, prepayment is required. In regards to tick-borne illnesses, if your labs do not show a Center for Disease Control (CDC) positive result, it may be necessary to repeat specific labs due to current regulations prior to initiation of treatment.
  • Labs prior to your visit:

  • If you have had testing for Lyme disease, or other relevant conditions, please send them along with this packet prior to your visit or bring the results to you.
  • Your second visit:

  • The purpose of the second visit is to review your new lab results and to further develop the plan of care specifically tailored to you. We do not fax any lab results prior to the second visit. Following this second visit, copies of lab results are available upon request. Please plan to spend up to one (1) hour for this visit.
  • Follow up visits:

  • Follow-up visits are scheduled according to your clinical needs and will vary according to the type of treatment you are prescribed. In general, follow-up visits are every 4-8 weeks depending on the complexity of your illness and current protocol. Please plan to spend thirty (30) minutes at these visits.
  • Prescription refill requests:

  • We kindly ask that you request refills during your office visits with the doctor. Should you need to have a prescription refilled in between visits, please call your pharmacy and have them fax a refill authorization request form to 415-665-6732. The office will not refill any request directly from patients unless an original prescription is needed. Please allow 48 hours for our staff to process this request. Neither the providers nor the staff have access to patient charts after hours or on weekends; therefore, prescriptions can only be handled during regular business hours.


  • Insurance:

  • Dr. Mischa Grieder, ND and his associates are fee-for-service, self-pay practitioners. We do not participate with any U.S. Federal Gov’t Health Insurances, including Medicare/Medicaid or Tricare. Traditionally most prescriptions and commercial labs (i.e. Quest, Labcorp) are typically covered by your insurance; however, we cannot guarantee coverage on behalf of your insurance company. We encourage patients to proactively contact their insurance representative to better understand and maximize their out-of-network benefits.
  • Payments:

  • Payment is due at time of services rendered. We require that you keep a current and active credit card on file to use for charges associated with our office. This may include office visits, treatments, testing, supplements, and cancellation/no-show fees. Please be prepared to supply your credit card number, expiration date and CVV or security code. In the event that you have a phone or zoom visit and we are unable to reach you for checkout, please be aware that we will charge the card on file for fees associated with your visit.
  • SFPMG accepts the following forms of payment: cash, personal checks, MasterCard, Discover, Visa and American Express, Health Savings Account (HSA) and Flexible Spending Account (FSA) cards. All checks should be made out to SFPMG. If your account happens to develop an outstanding balance, we encourage you to communicate with the practice manager but please be aware that your treatment may not be able to continue until your open balance is paid in full.
  • Superbills:

  • If you desire to submit a superbill for potential, out-of-network insurance reimbursement, please notify our office at time of service. Please note that requests exceeding five (5) superbills after the date of service may result in an administrative fee.
# of Superbills Fee Processing Time
1 – 5 $0 2 business days
6 – 10 $10 3 business days
11 – 20 $20 5 business days
21 – 30 $30 7 business days
31 – 40 $40 10 business days
41 + $50 10 business days

Cancellation and No-Show Policy

Our priority is to provide the highest-quality patient care to all of our patients and to be fully prepared for your visit. We kindly ask that you provide sufficient notice if you are unable to make your appointment. If we are not notified, please be aware that there will be a fee associated. We will allow an exception if you test positive for Covid (with proof of positive test results).


  • If any appointment is canceled 48 business hours or more in advance, we are happy to reschedule with no fee.
  • If you need to cancel or reschedule an office visit, zoom visit or phone visit with less than 48 business hours notice, you will be charged half of the appointment cost.
  • If an office visit, zoom visit or phone visit is canceled or rescheduled on the same day, you will be charged the full cost of the appointment.
  • All specialty IV procedures canceled or rescheduled with less than 48 business hours notice will be charged a fee of $300. Specialty procedures include: ketamine, ozone, IVIG, PK protocol, exosomes and NAD.
  • All other IV infusions canceled or rescheduled with less than 24 business hours notice will be charged a fee of $50.
  • Please note cancellations are only accepted via the patient portal, email, or directly speaking with a staff member.
  • Please be aware that if you are more than twenty (20) minutes late, you may need to reschedule your appointment and incur the above mentioned fee.