Noel JohnM. Carrasco,M.D.,FAAP
PAT MURPHY CARRASCO, BSN,MFA,cMHt
MAKE AN APPOINTMENT
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Phone:
928-282-4354
or
928-301-4647
MAKE AN APPOINTMENT
| New Client Interest Form |
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This form is a request for Dr. Carrasco to review your situation to help determine if your needs can be supported through the consultatioon services of Into Wellbeing Pc.
Last Name: City: State: Best Phone #: Email: Gender: Age Range:
How did you learn about our consultation services? Which consultation service are you interested in? Do you have any specific symptoms or established illness that you are seeking consultation on? If yes, what health issue are you seeking consultation about? Do you have a diagnosis?If so, please state: What are your symptoms? How long have you had the symptoms or health issue? What other health care professionals or healing arts practitioners are a part of your health care team? Do you have a primary care physician? Do you have any particular health goals that you would like to work towards? Do you have a particular health area that you would like more information about such as optimal nutrition, supplementation, Clinical Hypnosis, Stress Reduction, or referrals to other healing arts practitioners?
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" Choice is the life process. In every moment of awareness, be free to make new choices. Have no expectations, but rather abundant expectancy. "
Copyright © 2006, IntoWellBeing PC, All Rights Reserved.
Information and Scheduling
New Patient Information New patients are asked to: • Wear light-weight comfortable clothing. Dress slacks or skirts, yoga or stretchy exercise garb, thin sweats, or tee shirts. AVOID blue jeans, denim, or corduroy. You can bring a change of clothes with you if needed. You will remained fully clothed during your visit. • Bring in your medical or CAM (Complementary- Alternative Medical) records from previous health care providers. They should include labs, consultant reports, and reports of any radiologic studies. Do not bring in actual x-rays only reports. • Bring all medications, vitamins and supplements • Please refrain from wearing perfume or cologne that day. • Complete the New Patient Forms found below. You can download, print, and fill out these essential forms or request them in advance to save time prior to arrival. All pages are contained in this one Adobe Acrobat PDF file pick either for adult or pediatric. Scheduling information: Patients are seen one-at-a-time, and on time. New patient appointments are usually 1.5 to 2 hours long; time spent entirely with the doctor. Follow-up visits may run 30 to 45 minutes. Patients are scheduled into pre-established slots on a first come-first, first-serve basis. We do not overbook, so waiting time at the office is usually kept to a minimum. This also means that we cannot guarantee you an appointment on the exact day and time you wish to be seen, though all efforts will be made to accommodate urgent needs. Owing to the length of free time that must be available for a first visit, new patients appointments are usually scheduled in advance. Please arrive about 15 minutes early for that first visit to complete the necessary forms (or better yet save time by downloading these at the link to the bottom and pre-fill, or request in advance the forms). Office Hours vary by appointment. For first contact Please first fill out the New Client interest Form . Sorry , I do not respond to email inquiries at this time due to time constraints. Primary care is not offered and does not include hospital care or emergencies or 24/7 availability. PDF FILE |