New Client Paperwork

You will need to set up an account in the patient portal of SmartND (online EMR), accessible by clicking any button.

Your information will only be seen by Dr. Anne Thiel and will not be shared unless required by law.

 
 

Intake forms are required at least 2 business days before your consult to allow adequate time for me to prepare. If forms are not received, your first consult may be spent collecting necessary health information and recommendations discussed at a follow up consult.


For cancer support consults, your medical records must be received one week before your consult, otherwise consult will be rescheduled.


Health History Form

Required for all new clients. May take up to an hour to complete.


Informed Consent

Required for all new clients; read carefully to understand the limitations of seeking a consult.


Office Policies

Required for all new clients; read carefully to understand your role as a client.


Context of Care

Not required but this form gives me a greater understanding of how to best help you.

Due to the time intensive nature of manually entering information, I do not offer a paper version of the health history intake. Because I am a sole practitioner, I need to be able to communicate quickly with a large group of people and email allows me to do this in the most efficient manner. Thank you for understanding.