If you intend to email me sensitive data, I recommend you consider setting up a Protonmail email account (free via https://protonmail.com), which will keep your information securely encrypted and only accessible between ourselves. My email – but not the contact form via this site – runs through Protonmail. You can email me from any email system, but non-Protonmail accounts will not be encrypted.
Treatment consent forms:
PDF files
Privacy/ GDPR consent forms:
PDF files
Health questionnaire:
PDF version
Word document version
Online form
The following form is powered by Cognito Forms. Forms created in Cognito Forms are designed to comply with US and international regulations such as HIPAA, GDPR and CCPA, as well as provide PCI-Compliant payment and meet ADA standards for online accessibility.