To schedule a consultation with Dr. Prescott please contact our clinic via:
Phone: (208) 684-3368 OR e-mail: customerservice@erbzrx.com
If scheduling a phone consultation, new patients must print off, fill out completely and sign the following forms which will become your permanent chart in our office. For a child (newborn thru 12 years old) you will need to fill out – Child Health History, Adult/Pediatric Demographic and The Notice of Privacy Practices (HIPPA) forms. For an Adult (13 years old and up) you will need to fill out – Adult Health History, Adult/Pediatric Demographic and The Notice of Privacy Practices (HIPPA) forms.
All forms must be filled out completely and signed in the appropriate places and returned to our office via fax or via US mail before your scheduled appointment or phone consult. If you are coming to the office for an appointment you may bring the paperwork with you. Please be sure the paperwork is completely filled out and signed prior to your arrival.
Please read and/or fill out the following forms and send back to
Dr. Sandra Prescott N.D., N.M.D.
1194 W 600 S
Pingree, Idaho 83262
before your scheduled appointment.
Adult Health History Questionnaire
Adult Pediatric Demographic Form
Child Health History Questionnaire
Please print the testing instructions below for complete instructions when you receive your testing kit. The testing instructions.
