First Appointment Forms:
|Please click on and fill in indicated forms- they then can be submitted to us on completion. First save the forms to your desktop. Then open them up and fill them out. You can sign on line by following the instructions to your right. Also print a copy for your records in case there is a problem with submission.
First Choose the Appropriate Set of Forms- adult or child:
Adult Patient Form
Child Patient Form (Under 18)
The Following Forms Do Not Need to be Filled Out- Print Them for Yourself:
Fees and Policies for Patients Who Do the First Appointment in Person.
Fees and Policies for Patients Who Do the First Appointment by Phone or Webcam
Notices of Privacy Practices
For Patients Who Fly or Drive In for First Appointment:
Patient Information Booklet (read after first appointment not before)
Other Forms: (only fill out of we ask you to)
Request for Case File From Another Homeopath
Files From Other Homeopath Permission to Talk About Your Case
If You Lose the Following You Can Reprint It
|Signature Process : How to fill it out?
Step1: Click on signature box.
Step2: If you do not have an existing signature ID to use then choose "A new digital ID I Want to create now" then push next.
Step3: Accept the New digital OD file by pushing next.
Step4: Type in your name on the first line and your email address on the 4th line. If you are not in the United States change line 5 to your country. Then push next.
Step5: Then choose a password and enter it twice and push finish.
Step6: Choose your full name from the pull down Sign as list and the password you previously choose and push sign and it is done
Step7: To do more signatures on other forms it will be much simpler as this is already done
For More Information or to make an appointment contact:
Steve Waldstein RSHom (NA) CCH PCH
Classical Homeopathy, Inc.
1245 NW 22nd Avenue
Delray Beach, FL 33445