Office Policy


 

Your first visit will last approximately one hour and includes a comprehensive health history interview, examination as necessary, and development of an initial treatment plan.

To maximize your time with Dr. Haynes, please click on and download the following forms. These forms will take some time to complete, as several of them require a few days of logging information. Please review them immediately so you can plan your time accordingly. Your paperwork must be completed prior to your appointment time.

  • Patient Policy Form

  • Comprehensive Intake

  • Diet Journal and Body Temperature Log

  • Nutritional Informed Consent

  • Notice of Privacy Practices (HIPPA)

  • Release of Records

You may download these forms here:

Intake Forms

Please also bring:

  • Any laboratory reports from tests conducted in the last two years. (If you do not have your own copies, the Release of Records form will allow you to authorize other physicians to send copies of those reports to us.)

  • Any vitamins, supplements, and medications you are currently taking.

Office Policies

Payment in full is required at the time of your visit. We accept Visa, Mastercard, American Express, cash, checks and We Trade (for services only).

We do not bill insurance carriers directly; however, we are happy to provide you with the necessary paperwork for you to submit to your insurance carrier.

Cancellations require a minimum of 24 hours notice. You will be billed for your appointment without 24 hours notice.

Office Hours are Tuesday-Friday from 9am – 4pm. The dispensary is open during these hours as well. Please let us know your needs in advance, so we can prepare your items for you. Please allow 24 hours notice on items made in-house. Either call your supplement orders in to 721-2147 or use this handy form to compile and/or email your list ahead of time to info@DrAmyHaynes.com


Supplement Refill Form

What we offer

Featured Services

Location
Full Circle Natural Medical Clinic
521 South 2nd Street West
Missoula, MT 59801
Phone: 406-851-9272
Fax: 406-543-1020
Office Hours

Get in touch

406-851-9272