Chelation Maine accepting new patients
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Financing Available
for All Services & Labs:
Financing Terms


Purchase products through our Fullscript virtual dispensary.
________________ Functional Metabolic Mineral Testing for Optimal Health
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What is my body burden of Toxic Heavy Metals?
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anti-aging power supplements
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Patient Forms

 HEALTH QUESTIONAIRE:
For our new patients, please print out the following form, and fill out before your initial office visit:
New Patient Health Questionnaire

AGREEMENT FOR MEDICAL PHONE CONSULTATION:
This form must be filled out and on file in our office prior to phone consultations with Doctor Psonak.
Agreement for Medical Phone Consultation

OBTAINING MEDICAL RECORDS FROM YOUR PROVIDER:
To make your visit with the doctor more efficient, it is recommended that a copy of your previous medical records be available at the time of your visit.  If you need to obtain a copy of these records you should either contact your health provider directly, or the following form may be used to send to your health provider:
Request for medical records to be sent to us from your health care provider

REQUESTING YOUR MEDICAL RECORDS FROM US:
If you need a copy of your medical records which are in our office, you may use the following request form:
Request to release your medical records to a another health practitioner

PARENTAL CONSENT:
If the patient is a minor under the age of 18, and the parent/guardian is not present, the following form is required:
Parental consent form for a minor under the age of 18



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