1. Timeliness: Dr. Crout strives to be on time. Your appointment time is designated just for you. Arriving promptly will allow you to make the most of your appointment time. Arrive early if any paperwork needs to be completed (if not done online) or any other prep you may need.

2. Attendance: It is your responsibility to keep your scheduled appointments. This office does not provide reminder calls/notices.

3. Cancellation and No-Show: Cancellations of appointments can be made online up to 24 hours in advance. If less than 24 hours, you must call to cancel and please leave a message on the confidential voicemail system. A no show or late cancellation (of non emergent nature) will result in charge of full amount of that visit that must be paid prior to scheduling next appointment.

4. Payment: You are responsible for your bill at the end of each appointment. Payments by cash and personal checks accepted. A $30 fee for all returned checks must be paid prior to scheduling next appointment. Whole Person Wellness does not participate with any insurance network. Request itemized bill from Dr. Crout if you desire to submit to insurance for reimbursement (except for Medicare/Medicaid as Dr. Crout has opted out of Medicare).

5. Treatment: Appointments with Dr. Crout will include an Osteopathic structural exam and, if appropriate, Osteopathic Manipulative Treatment. This modality of care will be explained prior to, during and after the treatment as indicated for the patient’s needs. Signing this indicates consent to assessment and treatment with this modality of care, and other treatments as discussed and planned at each visit.

6. Pediatric patients: A legal guardian with medical decision-making capability are required to sign this document and thereby consent to minor’s evaluation by this office. A legal guardian must be present at each visit.

7. Confidentiality: Exceptions include- disclosure by you regarding intention to harm yourself or others; if you elect to communicate with Whole Person Wellness/Dr. Crout by email, please be aware that email is not completely confidential as all emails are retained in the logs of the internet service provider. Your record at Whole Person Wellness and the information contained within it will not be disclosed to others unless you direct us to do so or unless the law authorizes or compels us to do so.

8. Regarding COVID-19: I, the patient, understand I have the option to wear a face mask or not during the visit and office staff will not be masked. At Whole Person Wellness, we understand that health of an individual is each person’s responsibility and that each person supporting their immune system is of primary importance. Ask Dr. Crout if you'd like more info on this topic at your visit.

9. Emergencies: If you have a serious health problem that requires immediate attention, call 911.

10. HIPAA: The Health Insurance Portability and Accountability Act (HIPAA) provides safeguards to protect your privacy. Implementation of HIPAA requirements officially began on April 14, 2003. It is required that you are informed. Please read the complete text: http://www.hhs.gov/ocr/privacy/

Clinical care provided by Whole Person Wellness is by appointment only. The appointment reserves Dr. Crout’s time exclusively for that patient at that time. Dr. Crout aims for punctuality, so patients need to be prepared and ready to go at their appointment time or they are forfeiting part of their appointment. If the patient does not show for an appointment or cancels less than 24 business hours in advance, you may not be able to make another appointment.

Appointments with Dr. Crout will include an Osteopathic structural assessment and, if appropriate, Osteopathic Manipulative Treatment. This modality of care will be explained prior to, during and after the treatment as indicated for the patient’s needs. Signing this consent form indicates consent to assessment and treatment with this modality of care.