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Health History Form

We look forward to providing you with the highest quality medical care and service so that you can live a longer and healthier life. We know that everyone is primarily looking for concenience in a doctor’s office. These patient policies are designed to help you understand how Fusion operates so you can most efficiently access the healthcare you need. We greatly appreciate any feedback that you feel would help us serve you better…
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Pellet Form for Women

The Pellets Form for Women describes the list of symptoms that may occur after a pellet insertion. This form explains the Post-Insertion Instructions for Women and concerns women may have after inserting hormone pellets. If you have any concerns or questions about this form, please contact our office.
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Pellet Form for Men

The Pellets Form for Men describes the list of symptoms that may occur after a pellet insertion. This form explains the Post-Insertion Instructions for Men and concerns men may have after inserting the pellets. If you have any concerns or questions about this form, please contact our office.
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Medical Information Release Form

A medical form allows your information to be private unless given the information to share with another family member. Once you sign out this information, your medical information may be shared with the person or people on this form.
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Insurance Disclaimer

Preventative medicine and bio-identical hormone replacement is a unique practice and is considered a form of alternative medicine. Even though the physicians and nurses are board certified as Medical Doctors and RN’s or NP’s, insurance does not recognize it as necessary medicine BUT is considered like plastic surgery (esthetic medicine) and therefore is not covered by health insurance in most cases…
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HIPPA Privacy Policy Form

This form is a list of Privacy Practices and your Rights as a patient at Fusion. This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
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