Southern Maine Integrative Health


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Dr. Mulcathy's Background Information
Dr. Mulcathy's Background Information
General Info
Conditions Treated
New Patient Info & Patient Form
Integrative Medicine
Contact Info and Map
New Patient info & Patient Forms
 

Receipt of Notice of Privacy Policies & Consent Form

 

Registration Form

 
Adult Intake Form  

Child Intake Form

 

Individual Patient's Authorization Form

 
Office Policies  
Privacy Policy  
   

Due to the new Red Flag regulations, we are required to implement a plan in our office that will protect our patients from medical identity theft. All patients will have a copy of their photo ID placed in their file with a copy of their insurance card that has their name printed on it. Please bring these cards to your first visit, along with your completed Registration, Intake, and Receipt of Privacy Policy forms.