Our Privacy Policy

All health information in our office is treated as confidential, and we are careful in how we use it. This policy describes how your health information may be used and how you can get access to this information. This clinic strictly observes doctor-patient privilege, the US Constitution and laws, and we recognize that you control all information in your medical records and who sees it.

We will only release a patient's health information to a third party in three kinds of situations:

1. If the patient makes a written request to us for all or part of his or her health care records to be shared with another health care provider, imaging facility; or other entity; or
2. If the patient arrives to our office in a state requiring emergency care, in which case we would contact 911, and may need to inform 911 of your physical state of being: or
3. In cases of victims of abuse or threatened homicide or threatened suicide, or threatened harm to others, and in such cases, only to law enforcement agencies, 911 services and/or other emergency services.

Other than these special situations, we always honor your right to privacy under the Fourth Amendment of the US Constitution and HIPAA law, and your control over who sees any or all of your information, as well as federal and state privacy laws and regulations in order to assure you complete confidentiality regarding all of your health care information.

Please indicate your acceptance of this policy with your signature on the line below.

Permission to Share Medical Information

The following individuals may have access to my medical information:

Description of Procedure

Nutritional IV's including high dose vitamin C with additional nutrients, including most B vitamins, amino acids and minerals, in descending order by volume, as described in detail in the Cancer & Biochemistry videos on the https://NatureWorksBest.com website and as determined prior to each visit and specifically selected for each individual's current health circumstances.

If needed, you also consent to the administration of hydration IVs, alpha lipoic acid, and any other substance that you and your provider agree on. If agreed, this may include immunotherapy procedures.

You have the right to be informed of the procedure, any feasible alternative options, and the risks and benefits. Except in emergencies. procedures are not performed until you have had an opportunity to receive such information and to give your informed consent.

The procedure involves preparation of a sterile solution of liquid, sterile, water-soluble nutrients by one of your providers, for you specifically, and then inserting a needle into your vein, port or muscle, and injecting the solutions described by your provider in writing and oral consultation, and as described in detail on the NatureWorksBest.com website, with daily updates as needed by your health circumstances.

Risks of intravenous or intramuscular or subcutaneous therapy include:

1. Discomfort, bruising and pain at the site of injection.
2. Inflammation o f the vein used for injection, phlebitis.
3. Temporary fluctuations in blood sugar, cytokine reactions or inflammation, infection from fluids injected.
4. Severe allergic reaction, anaphylaxis, cardiac arrest and death; however, none of these have occurred a t this clinic to date.

Benefits of intravenous or intramuscular or subcutaneous therapy include:

1. Injectables are not affected by stomach or intestinal disease.
2. Total amount of infusion is available to the tissues.
3. Nutrients enter cells by means of diffusion along a concentration gradient.
4. Higher doses of nutrients can be given than possible by mouth without intestinal irritation

You have the right to consent to, or to refuse, any proposed treatment at any time prior to its performance. You have been informed of the means, method, medicine, substances, treatments, and the devices and instrumentality (IV content, IV preparation, needle access. IV tubing, gravity drip. IV pole, etc.).

Your signature on this form affirms that you have given your consent to the procedure(s) described above with any different or further procedures which, in the opinion of your provider, as discussed with you, may be indicated.

The procedure will be performed by or under the direction of a clinic healthcare provider with qualified nurses and medical assistants.

We strive to provide all of our patients with the best care and most attention we can. To ensure this, we make sure to schedule all appointments to give patients the maximum time available with the doctor to discuss everything necessary. If a patent misses an appointment, this is unfair to the other patients, as your appointment time could have been offered to a patient who needed it.

It is also unfair to us, because nursing and support staff must be scheduled in advance, based on the expected schedule of patients. To this end, we ask all our patients to call or email and cancel at least two working days in advance if they are not able to come to their appointment.

This gives us the chance to offer the appointment time to someone who may not have been able to get on the schedule otherwise.

For existing patients, if we do not receive a phone call, email or any other communication at least one working day (24 hours) before your appointment, we must charge a $75 missed appointment fee.

For Initial Consultations, if we do not receive a phone call, email or any other communication at least one working day (24 hours) before your appointment, you will forfeit the $150 new patient deposit.

We do understand that life is unpredictable and that emergencies can arise the same day as an appointment. These will be dealt with on a case-by-case basis. This is for true emergencies.

If you call after we have closed for the evening, please leave a message so that our office manager will receive it in the morning. Any messages on the phone in the morning before we open does not count as 24 hour notice, except in the case of a true emergency.

We appreciate and respect all our patients' time and ask that you please offer them the same courtesy by providing at least 24 hours notice when you are unable to make an appointment.