Intake documents for Kathy Devine, CNM, ARNP
Thank you for making an appointment with Kathy Devine at Seva Functional Medicine. We request that you please fill out/sign and submit the following forms online at least one week before your initial visit:
Intake and Health History
HIPAA Notice of Privacy Practices
Seva Functional Medicine Cancellation Policy
Seva Functional Medicine Medication Refill Pollicy
HIPAA Notice of Privacy Practices
Seva Functional Medicine Cancellation Policy
Seva Functional Medicine Medication Refill Pollicy
When you come in for your first appointment, please bring your insurance card so we can make a copy for our files, and please bring any relevant lab results from the past 2 years.
Please contact us with any questions, and thank you for trusting us with your health and wellness care!
Please contact us with any questions, and thank you for trusting us with your health and wellness care!