elemental medicine
Phone: 503.505.9677
​Fax: 503.427.9765
contact@elementalmedicinepdx.com
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New Patient Registration Packet (6 pages)

These forms provide the office with all of your contact information, outlines the financial obligations and is the privacy policy and consent form.  Also included is a health history form where you can indicate your current area of complaint, as well as a brief history of your past injuries, illnesses, medications and accidents.  It is 6 pages in length.

Fees for payment in full at time of service:

Fascial Manipulation:  $125 / 45 minutes

Missed Appointments: There is a $50 charge for cancellations within 24 hours of your scheduled appointment time.





For additional information, email contact@elementalmedicinepdx.com.

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