Naturopathic Physician and Acupuncturist
1201 West Main Street Hamilton, MT 59840
phone 406.375.0167 ● fax 866.225.2126
www.thehealthyplace.com
Welcome! I am honored that you have chosen me to help in your search for optimum health. This is your New Patient Information Packet. Please read, fill out and sign the attached forms and fax, mail or drop off this packet at least 24 hours prior to your appointment. This allows me and my staff to use your appointment time most efficiently. We offer a $25 discount at your first appointment if we receive your paperwork at least 24 hours prior. Bring any prior lab work, supplements and medications to your appointment. If you wish to cancel or reschedule your appointment, please notify our office 24 hours or more before your appointment. We charge a fee of one-half of the cost of the visit for missed appointments if less than 24 hours notice is given. It is our office policy to confirm appointments by phone one to two business days before your appointment. If you have an answering machine or voice mail, a message will be left. Many of my patients are sensitive to environmental substances, therefore we ask all patients to refrain from wearing strongly scented hair sprays, colognes, perfumes, aftershaves, etc. on the days you are here. If you have any questions please call our office. I look forward to meeting you!
Dr. Kelley received his pre-medical training with a BA in Psychology from Ohio University. Dr. Kelley then completed his Doctorate of Naturopathic Medicine from Southwest College of Naturopathic Medicine in Tempe, AZ in 2000. This school is an accredited four-year medical program, (4500 hours), specializing in natural therapeutics including basic sciences and clinical training. Dr. Kelley then went on to complete a Masters Degree in Oriental Medicine (2001) from Southwest Acupuncture College, (2643 hours), in Boulder, CO. After passing the naturopathic licensing board exams, Dr. Kelley obtained a license as a Naturopathic Physician in the state of Montana (2001), Arizona (2000) (ret.) and Vermont (2000). Dr. Kelley is also a licensed acupuncturist in Colorado (2004) and Montana (2001). Dr. Kelley is certified through the National Certification Commission for Acupuncture and Oriental Medicine as a Diplomate in Acupuncture from 8/31/01 to 8/31/13. Dr. Kelley has never had a registration, certificate or license suspended or revoked. Dr. Kelley is continually expanding his education with seminars and workshops several times a year, completing much more than the required continuing education hours. Dr. Kelley is a member of the Montana and Colorado Association of Naturopathic Physicians, the American Association of Naturopathic Physicians, American College for Advancement in Medicine, and American Association of Orthopedic Medicine. The practice of Naturopathy includes: western diagnostics/labs, botanical medicine, homeopathy, lifestyle counseling, nutrition and physical medicine. The scope of Chinese Medicine includes: acupuncture, needling and injections, Chinese herbs, (bulk teas, fluid extracts and patent formulas), moxibustion, and guasha. Dr. Kelley may utilize one or a combination of the above listed therapies in working with clients and has trained extensively in combining therapies to meet the health needs of the client. This office complies with all rules and regulations promulgated by the Montana Department of Public Health, including those related to the proper cleaning used in the practice of acupuncture and the sanitation of acupuncture offices. This office uses one-time use disposable needles only. As a client you are entitled to receive information about the methods of therapy, the treatment modalities used, and the duration of therapy if known. As a patient you may seek a second opinion from another health care professional, or may terminate therapy at any time. All clients are asked to pay in full at the time of the visit. All expenses for supplements, herbs, and homeopathic medicines are in addition to the cost of the treatment. I take great care, and am able with my education, to discern quality and potency. I use physician-only lines of supplements that are what they say they are, and that are designed to be very potent and therefore only used by physicians. These companies were created by doctors like me for doctors like me that “know the difference” and they cater to my particular, critical and demanding standards. Further, they often make available substances that only doctors like me know to use, and that the lay market does not know, understand and therefore demand so that they are not found in the lay market. I am able to use quality, potent materials that produce dramatic results for people working to improve their health. This is vital to the success of my patients.
Fee Schedule: Non procedure office time is prorated.
| Initial Visit (60 minutes) |
$360/hour |
| Initial Visit (45 minutes) |
$270 |
| Return visit limited (30 minutes) |
$180 |
| Return visit brief (15 minutes) |
$90 |
| Return visit short (5 minutes) |
$30 |
| Regenerative Injection Therapies (prolotherapy, etc) |
$250 |
| New Patient Acupuncture |
$150 |
| Acupuncture follow up |
$100 |
Emails: Please no emails as phone calls are the preferred way for us to communicate.
*Very Important Information * Please Read Carefully and Sign After Reading
I am here to help you take care of your health in the best way that I know how. I realize you came in about health and not finances. The following is to assist in understanding the financial policies.
Payment Requirements: Appointments must be paid for at time of service. I accept Visa, Master Card, Discover, check or cash. Please contact our desk for more details. You will be charged a $25 fee for returned checks.
Appointments: We require 24 hours notice if you need to change or cancel your appointment. You will be charged a fee of 50% of the total cost of any missed appointment if the 24 hour advance cancellation policy was not met.
Records: I will keep a record of your health care. I will not disclose your record to others unless you direct us to.
Insurance and Medicare: I do not offer insurance billing as I do not contract with any insurance company. However, we can provide you with a superbill which you can then submit yourself for reimbursement. Remember, payment is expected at time of service and any insurance payments will go directly to you. I am unable to bill Medicare or Medicaid! Medicare will not reimburse you for services rendered with me and you should not seek reimbursement from Medicare.
Also, my malpractice insurance requires me to inform you that treatment results are not guaranteed and naturopathic medicine is not a substitute for conventional medical treatment.
I have read the above information and my signature endorses my understanding of these conditions.