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Dr. James partners with persons with cancers and other serious illnesses to construct a "whole person" roadmap
leading to health and well-being. To immediately receive a free copy of my groundbreaking book, Conquer Your
Fear of Cancer, click here now to sign up
for a free homepage. Clients and Patients -> New Patient Intake Package New Patient Intake PackageBelow you will find each of the forms and other information contained in our new patient/client package. Before you come in for an office visit, please follow the instructions below:First: Read all the information contained within this package. Second: To help us provide you with the most comprehensive healthcare possible, you will need to fill out the following forms contained within this package. This information is critical in assessing your individual situation, needs, and determines whether you can benefit from our program. Third: Congratulations! You have made a very important decision by taking the first steps toward optimal health and the prevention and/or amelioration if not cure of chronic illness. Fourth: To help prepare you for your interactions with the Doctor, please take the following steps: A. Sign up for a FREE HomePage on Dr. James' website by clicking here. After signing up, a free copy of his new e-book, Conquer Your Fear Of Cancer, will be placed on your HomePage. Read as much of this as is possible before the first visit.Fifth: An Important Notice for Medicare Patients. Now please fill out all of the following forms, sign where indicated, and return them to the Center for Contemporary Medicine or fax to (734) 973-8709. You may download each form below in either HTML or PDF formats. Welcome Letter (HTML format) Please print, sign, date, and fax the following to (734) 973-8709 prior to your first visit with Dr. James. Step 1 (Required): Informed Consent (HTML format) Step 2 (Required): Fee Schedule (HTML format) - Sign and FAX to Dr. James Step 3 (Required): Patient Information/Patient Insurance Information (PDF format) Step 4 (Required): Authorization to Request/Release Client Information (PDF format) - Print, fill out DOB and SSN and FAX to Dr. James Print out Steps 1-4. Fill in the appropriate information and fax to (734) 973-8709. Please submit the following two forms online. Step 5 (Required): Medical History Form (Submit Online) Step 6 (Required): Health Analysis Questionnaire (Submit Online) Directions to Our Office Questions or Comments? Contact our Office Assistant, Demetra Bennett, at (734) 973-8700. Thank you for your interest in the Programs of the Center for Contemporary Medicine. FAX: 734-973-8709 |
