New at NPMAW, we are now offering Doterra AromaTouch Technique! 

We also offer a free class on essential oils the first Monday of every month!

Need an Appointment?

Give us a call at:

 

716-616-9000

 

Or send us an e-mail.

 

Contact Details

Natural Pain Management and Wellness

2316-2318 Wehrle Drive

Williamsville, NY 14221

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Office Hours

Monday: 8am - 8pm

Wednesday: 8am - 8pm

Thursday: 8am-5pm

Friday: 8am - 8pm

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Chiropractic New Patient Intake Forms

New Patient Intake Form
Needed for your first visit. Please print, complete and bring with you for your initial appointment.
NPP-Complete.pdf
Adobe Acrobat document [323.2 KB]
Insurance Information
Please include any insurance info you can for your first visit.
Insurance information.pdf
Adobe Acrobat document [8.7 KB]
HIPAA Signoff
Please complete and bring with you to your initial appointment.
HIPAA-signoff.pdf
Adobe Acrobat document [58.7 KB]
HIPAA Privacy Notice
This is for all new patients to review and keep.
HIPAA-Privacy Notice.pdf
Adobe Acrobat document [71.1 KB]
Compliance Form
Please complete, sign, and bring with you to your initial appointment.
Patient Compliance.pdf
Adobe Acrobat document [35.9 KB]
Cancellation Policy
Please complete, sign, and bring with you to your initial appointment.
Cancellation policy.pdf
Adobe Acrobat document [12.0 KB]

Additional Forms for Maternity or Pediatric Patients

Maternity Patient Information
For all expecting mothers, please complete and bring to your first appointment.
Maternity Patients only.pdf
Adobe Acrobat document [31.1 KB]
Pediatric Patient Intake and Consent
Parents, please complete the information in this form for any patient under the age of 18. This will be required before any treatment can be done for the child.
Peds intake and consent.pdf
Adobe Acrobat document [19.3 KB]

Massage Patient Intake Forms

New Massage Patient Informational Form
This form is needed for your first massage appointment. Please complete and bring with you to your initial appointment.
massage paperwork.pdf
Adobe Acrobat document [167.9 KB]
Compliance Form
Please sign and bring with you to your initial appointment.
Patient Compliance.pdf
Adobe Acrobat document [35.9 KB]
Cancellation Policy
This form is needed for your first massage appointment. Please complete and bring with you to your initial appointment.
Cancellation policy.doc
Microsoft Word document [22.5 KB]
HIPAA privacy notice
Please review and retain for your records
HIPAA-PrivNot.doc
Microsoft Word document [35.0 KB]
HIPAA sign off
Please sign and bring this form to your first visit.
HIPAA-signoff.doc
Microsoft Word document [20.5 KB]

Nutritional Counseling Intake Forms

Nutrition New Patient Intake Form
Needed for your first visit. The form is lengthy because it is important we understand your history and current challenges. Please complete and bring to your initial appointment.
nutrition intake.pdf
Adobe Acrobat document [188.5 KB]
HIPAA Signoff
Please complete and bring with you to your initial consultation.
HIPAA-signoff.pdf
Adobe Acrobat document [58.7 KB]
Compliance Form
Please sign and bring to your initial consultation.
Patient Compliance.pdf
Adobe Acrobat document [35.9 KB]
Insurance Information
Please complete and bring to your first consultation.
Insurance information.pdf
Adobe Acrobat document [8.7 KB]
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