Live long and prosper.

  Appointments & Forms for Patients 
  New Patients / Established Patients


Welcome to our Appointment site. 

We have included, for your general information, a biography of each practitioner, services that each offers, and forms that need to be completed before your appointment.

Kirk A. Melville, MD

Elizabeth L Schultz,DO,FACOG
  
    

Mel McDonald,ND,DOM,LAc
Dr.McDonald

   Biography
   Services Provided
  
Medical Modalities
   Make Appointment

   Forms to complete before appointment
       1. New Patient Forms:
         a.
Men's Initial Health History
         b.
Women's Initial Health History
       2.
Medical Release Form
       3.
Lab Authorization Form
       4.  Complete if >40 yr old or <40  
             with family history of colon cancer 
         a.
Colorectal Cancer Info
         b. Colorectal Cancer Consent Form
       5. Other Initial Forms
         a. Allergy/Sensitivities

         b. Exercise&Emotional Health
 

 

   Biography
  Services Provided
  Medical Modalities
  Make Appointment

 Forms to complete before appointment
  A. New Patient Forms:
      1. Women's Initial Health History
      2. Medical Release Form
      3. Lab Authorization Form
      4. Complete if >40 yr old or <40 
             with fam hx of colon cancer 
        a. Colorectal Cancer Info
        b. Colorectal Cancer Consent Form
      5. Other Initial Forms
        a. Allergy/Sensitivities
        b. Exercise&Emotional Health
  B. Established Patient Forms 
        a. GYN Annual Forms
        b. Demographic Form
        c. MSQ-Medical Symptoms

   Biography
   Services Provided
  
Medical Modalities
   Make Appointment

   Forms to complete before appointment
       1. New Patient Forms:
         a.
Men's Initial Health History
         b.
Women's Initial Health History
       2.
Medical Release Form
       3.
Lab Authorization Form
       4.  Complete if >40 yr old or <40 
             with family history of colon cancer 
         a.
Colorectal Cancer Info
         b. Colorectal Cancer Consent Form
       5. Other Initial Forms
         a. Allergy/Sensitivities

         b. Exercise&Emotional Health

 

GENERAL INFORMATION ABOUT OUR APPOINTMENT FORMS:

Our physician's ability to draw effective conclusions about your present state of health and how to improve it depends, to a significant extent, on your ability to respond thoughtfully and accurately to these written questions and those posed by the clinician during your consultation.  Health issues are influenced by many factors.  Accurately assessing all of these factors and comprehensively managing them in an individualized treatment plan is the best way to deal with your particular health challenges.  Your careful consideration of each of the following questions will enhance our efficiency and will provide for more effective use of your scheduled consultation time.       

* A "New" patient is anyone who has NEVER been seen in our clinic or a 
RETURNING PATIENTS
we have not seen in over 3 years.
Please fill out all of the pertinent forms for the physician you are seeing and bring them to your appointment.
Failure to do so may postpone your appointment.

All forms are viewable in Adobe 6.0.  Get Adobe Reader.
If you do not have Adobe Reader, please download 
the appropriate program from the following links.

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English/Windows

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English/Macintosh 

 

General Office Information: 
Phone: 706.769.0720  
Fax: 706.769.8754   

 
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Revised last: 2/2008