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NEW CLIENT - INITIAL ASSESSMENT INSTRUCTION WEBPAGE - B "Informed Consents" Steps 4 & 5
INFORMED CONSENTS U.S. Mail Originals of Steps 4 & 5 Within 24 Hours - Thank You!
Step 4
INFORMED CONSENT - CLINICAL NUTRITION PROGRAM (1 Page)
Please open PDF Document to the right and print two copies.
Read, INITIAL, SIGN AND FILL in blanks on this policy form and U.S. mail both signed Original Informed Consents (Steps 4 & 5) to Dr. Smith within 24 hours.
When you receive your Clinical Nutrition Reports and Personal Education Program Binder, please insert your copy into section #10.
Please open PDF Document to the right and print two copies.
Read, INITIAL, SIGN AND FILL in blanks on this policy form and U.S. mail both signed Original Informed Consents (Steps 4 & 5) to Dr. Smith within 24 hours.
When you receive your Clinical Nutrition Reports and Personal Education Program Binder, please insert your copy into section #10.
Information provided in website for nutritional educational purposes only and not for diagnosis or treatment of any medical condition, disorder or disease.
MAILING ADDRESS: P. O. BOX 4652, WICHITA FALLS, TX 76308-0652
Copyright 2004 Dr. Donna F. Smith -- .NET 8/22/18 - Last Website Update: JULY 31, 2019, 4 PM CST
