Consent to Treatment

It is my understanding that Astrid Pujari MD PS may use alternative approaches to wellness. I choose to explore this expanded approach to wellness of my own volition. I agree to maintain my own primary care physician, with the understanding that Astrid Pujari MD PS does not provide primary health care. I also understand that Astrid Pujari MD PS is a personal wellness consultative service and their providers' guidance is advisory but the sole decision is mine about any suggestions given. I agree to discuss any suggestions with my primary health provider prior to implementation.

Scheduling Appointments for Integrative Medical Coaching Package

Integrative Medical Coaching Package

Policy for Scheduling Appointments

For the INITIAL INTAKE (first appointment) you can book your appointment either ONLINE or with the OFFICE.

ALL FOLLOW UP APPOINTMENTS with Dr. Pujari EXCEPT the Initial Intake will need to be scheduled with the OFFICE.

You must complete the Initial Intake with Dr. Pujari before scheduling the nutrition consult. The specific nutritionist is designated by Dr. Pujari, and you will receive information about with whom and how to schedule from the office.

For any questions, please feel free to contact the office.

info@AstridPujariMD.com

Payment Policy

I agree to make payment in full prior to, or on the date of service. I understand that Astrid Pujari MD has a 48-hour cancellation policy for appointments. Payment in full is due for any appointment cancelled or rescheduled within the time windows stated previously. There is a 10% administration fee for all payments by credit card if a payment needs to be voided or refunded for any reason. I understand I may request a super bill to submit to my insurance company, provided that I reside in Washington state. Neither employees, staff or independent contractors associated or affiliated with Astrid Pujari MD PS or it's affiliates make any guarantee or representation regarding insurance coverage or reimbursement. Patients are solely responsible for confirming coverage, benefits, and financial responsibility with their insurance plan prior to receiving services.

I have read, understand, and agree to the above stated payment policy.