New Patient Registration Packet (4 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 4 pages in length.


For additional info, email contact@elementalmedicinepdx.com.

Fees for payment in full at time of service:

Carrie Ebling DC, LMT #8058
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Wellness Massage    -     $95 / 60 minutes 
                                             


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Student and Senior Discount: $75 for 60 minutes