Introductory Patient Information

Transcription

1 Introductory Patient Information 884 Portola Road, Suite A-5 Portola Valley, CA (upstairs in the Chiropractic Center) Phone: (650) Fax: (650)

2 WELCOME TO FIVE SEASONS! It is our pleasure to welcome you to our practice. Our team is dedicated to ensuring your experience meets and exceeds your expectations. We believe your care is hugely important as our biggest asset is our good health. We have carefully crafted a suite of programs and services to help guide you through any necessary diet or lifestyle transitions you are looking to make. For your convenience, we have enclosed some information about our company and the services we offer. Our door is always open to you. We strive to be the kind of company that personalizes your health plan in a warm and welcoming environment. Let us know how we can help you feel at home in our practice. We understand that you have a choice when it comes to your health, and we are grateful that you have trusted us to be on your health-care team. Information about Five Seasons and all relevant patient forms are available through our website, We look forward to working with you. If you have any questions, feel free to call us at Wishing you the best of health and happiness, Courtney Jonson, LAc.

3 PERSONAL HEALTH MANAGEMENT Functional Medicine addresses the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. It is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century. COMMON UNDERLYING CAUSES OF DISEASE Guidance and tools are provided to establish your wellness and vitality by eliminating negative health impacts, replacing nutrient deficient building blocks and implementing sustainable lifestyle changes so that the body s self-healing mechanisms can function optimally. Interventions often include proven botanicals, detoxification of toxins, specialized micronutrient supplementation, Chinese Medicine, and homeopathy. Keys to Restoring Your Health & Longevity 1. Address Your Daily Nutrition 2. Balance Your Blood Sugar, Stress, and Your Hormones 3. Cool Off Inflammation 4. Build a Healthy, Strong Gut Microbiome 5. Enhance Detoxification 6. Boost Energy Metabolism 7. Regulate Your Energy & Calm Your Mind

4 FEE SCHEDULE CONSULTATIONS Your initial consultation will last approximately 90 minutes. Please plan on being in our office for an hour and 45 minutes to go over follow-up steps and check-out. During this time, we will review your medical history, relevant lab work, your metabolic assessment, and discuss treatment plans and/or programs that may be suitable for you. Nutritional therapy and laboratory/diagnostic testing are integral components of your treatment plan. Test results are used to design your personal health care program as well as uncover the root causes of your medical condition. Nutritional supplements are often recommended and we will help you select and find the highest quality products. Costs of all testing will be reviewed with you before labs are drawn. You will receive all final lab results and be guided through their interpretation at your follow-up visits. INITIAL CONSULTATION FEE Initial Metabolic Assessment: $240 (90 mins) - includes time to review next steps FOLLOW-UP CONSULTATION FEES Office Visit or Phone Follow-up (60-minutes): $240 Office Visit or Phone Follow-up (30-minutes): $120 Acupuncture Session (up to 75-minutes): $120 Therapeutic Thai Massage (90-minutes): $150 TURN KEY TWO STEP PROGRAMS Nutritional Tune-Up (Blood Test + Consultation): $325 Adrenal Health Profile & Report of Findings: $220 PROGRAM FEES Start Fresh: 28 Day Cleanse (6 Weeks): $485 Live Clean: Cleanse & Restore (3 Months): $1295 Total Vitality Program (3 Months): $870 Stay Well: Health for All Seasons: Varies

5 CLINICAL PROGRAMS Our practice offers specialized, cost effective nutrition and lifestyle programs for those wishing to regain their health and recover from chronic illness. These programs have been designed to save time and money in the long run by providing the necessary time for consultations to review lab tests, modify your treatment plan and review educational material fundamental in developing the foundation for your lifelong health and selfcare. Start Fresh 28-DAY CLEANSE 6 Weeks $485 investment ($590 value) Start Fresh 28-Day Guide and Nutritional Supplementation Meal Plans, Recipes, Diet & Lifestyle Guidelines Live Clean CLEANSE + RESTORE 3 Months $1295 Investment ($1910 value) Start Fresh 28-Day Guide and Nutritional Supplementation Meal Plans, Recipes, Diet & Lifestyle Guidelines Total Vitality AT YOUR OWN PACE 3 Months $870 Investment ($1560 value) Personalized Nutritional Program Meal Plans, Recipes, Diet & Lifestyle Guidelines 1 Hour of Consultation 4 Hours of Consultation 4 Hours of Consultation Educational Materials on Blood Sugar, Gut Health, and Liver Detoxification OPTIONAL OFFER 4 Acupuncture Sessions $380 ($480 Value) 4 Hours of Coaching 4 Hours of Coaching 10% discount on all supplements for the duration of the program OPTIONAL OFFER 8 Acupuncture Sessions $700 ($960 Value) 10% discount on all supplements for the duration of the program OPTIONAL OFFER 8 Acupuncture Sessions $700 ($960 Value) MAINTENANCE PROGRAM Stay Well Health for all Seasons Monthly Drop Ship of Clearvite & Omega-3 oil + 10% of all other supplements 20% off annual Start Fresh Program 25% of Five Seasons Service Menu Follow-Up Lab Work as Needed w/o hassle Seasonal Wellness Inspired Promotions **$125/month (NO Problems - Opt out at any time)

6 DIAGNOSTIC LABS The laboratory testing done in Functional Medicine is one critical part of creating your personalized treatment plan. Blood tests are done at our Partner Sites, and stool, urine and saliva are done in your home with a special kit. Some of the Functional Medicine laboratory testing we routinely do includes the following: Blood Chemistry Comprehensive Bio-Screen Panel This comprehensive blood panel includes a CBC with differential, full metabolic chem panel, full thyroid panel (TSH, Total T4, Total T3, T3Uptake, Free T4, Free T3, rt3, TPO and Antithyroglobulin), Vitamin D, Homocysteine, CRP-hs, Ferritin, Hemoglobin A1C, Fibrinogen, and iron saturation. Cash - $279 Bio-Screen Sustain Panel This panel mimics the Comprehensive Bio-Screen but doesn t include the thyroid antibodies or free thyroid hormones. It is a great baseline for those without thyroid symptoms or as a followup to the Comprehensive Bio-Screen. Cash - $206 Thyroid Advantage Panel This is the preferred panel for comprehensive thyroid evaluation (also included in Comprehensive Bio-Screen): TSH, Total T4, Total T3, T3 Uptake, Free T4, Free T3, rt3, TPO & TBG Antibodies Cash - $148 Bio-Screen Sustain Foundation Panel The panel includes a CBC with differential, full metabolic chem panel, a basic thyroid panel (TSH, Total T4, Total T3, T3Uptake), and magnesium. Cash - $120 Gastro-Intestinal Health GI Effects Stool Analysis: Comprehensive Digestive Analysis This test evaluates several components of bowel function, including digestion, nutrient absorption and bowel ecology. This test is useful for people with irritable-bowel symptoms, acid reflux, GERD, and for those with autoimmune disorders, inflammatory diseases or energy-deficit conditions such as chronic fatigue syndrome or fibromyalgia. This profile is recommended for all chronic GI problems, energy issues, skin disorders, and many other systemic diseases. Co- Pay - $99; Cash - $499

7 Intestinal Antigenic Permeability Screen ( Leaky Gut Assessment) This test measures intestinal permeability to large molecules which inflame the immune system. It identifies the damaging route through the intestinal barrier. It is recommended for patients who present with multiple complaints, suffer from abnormal immune cell count and function (including autoimmune diseases), and/or complain of food allergies and intolerances. Cash - $195 Wheat/Gluten Proteome Reactivity & Autoimmunity This test accurately identifies gluten reactivity. It measures antibody production against 9 wheat proteins and peptides and 3 essential structure enzymes. It is recommended for patients that have GI symptoms, suffer from multiple-symptom complaints, and/or those that suffer from depression/mood disorders. Cash - $325 Entero-Lab Food Sensitivity Stool Testing - (Ideal for Children) This comprehensive scope looks for intestinal disorders related to gluten and other food sensitivities, autoimmune response, fat malabsorption, and genetic gluten sensitivities. Varies: Cash - $269-$369 Gluten- Associated Cross-Reactive Foods & Food Sensitivity Some people who give up gluten only feel marginally better. Research has shown that many gluten-intolerant people cross-react with other foods. In other words, their body erroneously recognizes other foods as gluten and reacts accordingly. Fortunately it is now possible to test which foods might be provoking a cross-reaction to gluten, which you can read about at Cyrex Labs. Cash - $325 Immune Health Multiple Autoimmune Reactivity Screen Evaluation This test measure predictive antibodies, some of which can appear up to ten years before the clinical onset of disease. It is recommended for patient that have been diagnosed with an autoimmune disorder, as they commonly develop additional autoimmune conditions. It is also important for those with chronic increased intestinal permeability, which is the gateway for environmentally-induced autoimmune disorder. Cash - $575

8 Nervous System & Hormone Balance Adrenal Stress Hormone Evaluation The Adrenal Stress Panel evaluates stress, a leading cause of chronic disease and functional health disorders. It is a simple non-invasive test utilizing four saliva samples collected at specified time periods during the day. Since the human adrenal gland does not secrete its hormones at a constant level throughout the day, the Adrenal Stress Test provides you with a comprehensive assessment of adrenal function throughout the daily cycle. Co-Pay - Varies; Cash - $120 Neuro-Sleep Evaluation Neurotransmitters and hormones (cortisol and melatonin) active at night can be measured by using a simple urine and saliva test. These results can tell you if any neurotransmitters and hormones are out of balance. This is ideal for individuals experiencing difficulty falling asleep, staying asleep or having restless sleep. Co-Pay - Varies; Cash - $250 Female Hormone Cycle Map The Female Hormone Panel is a non-invasive test consisting of 11 saliva specimens collected during specified time periods throughout the menstrual cycle. The ovaries are a major component of the female reproductive cycle and they release hormones in a cyclical manner that is referred to as the menstrual cycle. The Female Hormone Panel provides a dynamic mapping of the levels of female hormones throughout one s cycle, helping us personalized recommendations for optimizing balance. Co-Pay - Varies; Cash - $200 Neuro-Endocrine Panel Menopause is a natural and usually gradual change in glandular function in women resulting in substantial shifts in hormone levels. This panels provides measurements of sex hormones, adrenal hormones and urinary neurotransmitters to better evaluate menopause, sexual dysfunction, PMS and other neuro hormonal imbalances. Co-Pay - Varies; Cash - $270 Nutritional Testing Organix - Organic Acids The Organix Comprehensive Profile is a nutritional test providing insights into organic acids and a view into the body's cellular metabolic processes. Organic acids are metabolic intermediates that are produced in pathways of central energy production, detoxification, neurotransmitter breakdown, or intestinal microbial activity. Marked accumulation of specific

9 organic acids detected in urine often signals a metabolic inhibition or block. The metabolic block may be due to a nutrient deficiency, an inherited enzyme deficit, toxic build-up or drug effect. Several of the biomarkers are markers of intestinal bacterial or yeast overgrowth. The Organix Comprehensive nutritional test profile provides vital patient information from a single urine specimen. This organic acids nutritional test is valuable for determining: Co-Pay - $129; Cash - $336 Functional vitamin and mineral status Amino acid insufficiencies like carnitine and NAC Oxidative damage and antioxidant need Phase I & Phase II detoxification capacity Functional B-complex vitamin need Neurotransmitter metabolites Mitochondrial energy production Methylation sufficiency Lipoic acid and CoQ10 status Markers for bacterial and yeast overgrowth

10 FREQUENTLY ASKED QUESTIONS Is Courtney Jonson, LAc. a primary care provider? Courtney Jonson, LAc. is a primary care provider but she does not provide acute care services. She will work with you closely as consultants and coaches in preventive, nutritional and functional medicine to help you address the roots of chronic health problems. She can also confer with your primary care doctor if required. Do I have to see Courtney Jonson, LAc. in person for my medical consultation? No, her medical license does not require that she meet with a patient in person in order to provide an initial medical consultation. However, it is strongly recommended that your visit be done in person to develop a sense of rapport and connection. Follow-up appointments can be arranged by phone or in the office. How can I order the supplements I need? At this time, please supplement re-order requests to info@fiveseasonsmedical.com. Nutritional products from Apex Energetics can be reordered directly from the company by using our patient code. Please call and give their staff our code P2658. Where do I go to do the testing? Some testing can be done through conventional laboratories and others are only available through specialty laboratories. During your consultation, we will determine which tests are needed and review testing recommendations, instructions (ex. fasting or non-fasting, etc.) and costs. Some testing can be performed at home with test kits to collect urine, saliva or stool. Others may require you to go to a local laboratory to have blood drawn. In all cases, we will assist you in coordinating initial and follow-up testing. Do you take insurance? Five Seasons does not accept insurance for consultations, and we do not file insurance claims on your behalf. However, we will provide a detailed receipt of services performed for you to submit to your insurance carriers. If your insurance covers acupuncture, we are out-of-network providers and will submit on your behalf after documentation of your coverage. Many of the labs are covered by your insurance with a co-pay. We will discuss these details with you on the day of your appointment.

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