Forms

Thank you for choosing Today Integrative Health + Wellness for your healthcare.  We are excited to work with you!

To prepare for your visit, please take a peek at the forms we’d like you to fill out.  You can either print them and fill them out and bring them with you or plan to arrive to your appointment 15-30 minutes early to complete them in office.

The Welcome Packet contains helpful information including points of contact for scheduling and after hours needs as well as policies around your care and insurance billing.  We do not verify your benefits in advance of your appointment.  It’s important for patients to be in charge of knowing what’s covered and what’s not.  This packet has a helpful worksheet to guide your conversation with the customer service person.

The New Patient Intake Form will help your physician have a full understanding of your health goals and history — Standard and thorough medical stuff.

The Review of Systems forms helps your doctor stay aware of changes in medications, supplements, and insurances.  It prompts you to check in on your body from head to toe.  Your doctor can then get a better sense of the whole picture.

—- Requesting your medical records —

Below are forms that you will need when requesting medical records. Please be mindful of the time and expense in transferring large volumes of records. For these reasons, we discourage people from simply selecting “entire medical record”.

We can provide the records for your last 3 visits and your most recent lab results at no charge. Record requests that exceed 25 pages will be subject to an administrative fee of $35 plus the cost of postage.

Please request only the most important parts of your record. Your healthcare provider can help make the determination about what’s most important. It’s very helpful to limit the timeframe of the request to the last year or two years, or simply request labs and imaging for a specific timeframe.

Please allow 7-30 days to process your request.

You may fax the records request form to 503-208-8025.

You may also send the form to
Today Integrative Health + Wellness
Attn: Medical Records
PO Box 86465
Portland, OR  97286

Release of Records (from Today to another provider)

Release of Records (from another provider to Today)

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