Patient / Member Services: Intro

About Our Patient/Member Services

 Everyone who has ever been a participant in Beverly Coleman's services or activities is welcome to request a "key" (username and password) in order to access our Patient/Member services.  Simply click the "Sign-up and Login" on the sidebar.  Fill out and submit the Registration Form.  We will process your information and email a "key" to you as quickly as possible. 

If you would like to have a "key" into this section but have not yet participated in any of these services, we invite you to begin by visiting the Pathways to Wellness --> Consultations --> Wellcare Plans where you will step by step find your way to our Initial Patient Information Form.  Once you become a program participant, you too will be welcomed into our Patient/Member Services below:

Patient Forms

All patient forms are conveniently located in this section!  Some forms can be filled out and submitted electronically and others must first be printed, filled out by hand and then faxed or mailed to my office. The Initial Patient Information form,  can be filled out online and submitted electronically.  Upon receiving this form, we will better be able to determine which Wellcare Plan will best serve your wellness needs and goals. 

• Initial Patient Information Form   
• Health History
• Family Health History
• Diet Inventory
• Enneagram Questionnaire
• Self-Rating Depression Scale
• Self-Rating Stress Test
• Metabolic Typing Questionnaire
• Emotional Cycle Chart
• Nutrition and Wellness Contract
• Consent to be Treated (onsite Acupuncture)
• Patient Authorization to Release Information
• Request for Health Records
• Member/Patient Services Evaluation Form

Referrals

•  Staff
• Medical Services

Discussion Room

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