New Patient Information

We Invite You To Become A New Patient

If you have interest in becoming a new patient at Utah Natural Medicine, please call our receptionist at 801-363-UTAH(8824). We will be happy to answer any questions, help you decide which doctor may be best for you, and schedule an appointment.

When you have made an appointment, you can access all of the necessary forms by clicking on the link below. Download and print these forms and fill them out at your convenience and bring them with you for your appointment. If you have difficulties with the forms for any reason, please call our office and we would be happy to send you them.

These are some steps to help you be prepared for your first appointment.  Being prepared and on time allows you to gain the most from your experience.

• Bring all medications, herbal medicine, or other supplements with you. 
• Bring copies of all relevant or recent medical lab results.  
• Make copies of the Diet and Lifestyle Diary and fill out as instructed on the form.  You will need to start this diary at least one week prior to your appointment if you're able to do so.
• Fill out all forms in the New Patient Information and Intake Packet prior to your visit.  If you wait to fill this form out at the clinic on the day of your visit, please allow for at least 30 minutes prior to the scheduled time of your appointment.

Doctor Fee Schedule

Many insurance companies, flex plans, and health savings accounts will cover visits with us as Out of Network Providers. For all patients with health insurance and those without insurance, we ask that you pay for your visit at the time of service. We can provide a receipt/ “superbill”, including necessary codes and information for reimbursement for those who wish to submit for having seen an Out of Network Provider.

Dr. Matthew   New Patients:  Adults $240   Pediatrics $150                                                            Return Patients:  Adults $55-120   Pediatrics $45-85 based on time and complexity.

Dr. Rachel   New Patients: $360 (approximately 90 min)  Return Patients: $60/15 min

Patient Intake Forms

To download our New Patient Information and Intake Packet Click Here.

To download our Breast Thermography Forms Click Here . Note: This is only for those patients coming to our office specifically for a scheduled Thermography appointment. 

 If you need only one of our forms you can select them from below.

 

Patient Information

Intake Form

Diet and Lifestyle Diary

Financial Agreement

Informed Consent

HIPAA

Breast Thermography Intake