New Clients/Care Givers

Welcome Client and Care Givers

Your health and wellness is of the utmost importance to Medication Therapy Management Solutions. In order to optimize youur health and wellness, we request your assistance in gaining information about your current medication therapy and health records. This information will be held in Confidential HIPPA compliant records of which only Medication Therapy Management Solutions has access.

Steps for the Client/Care Giver

i. Download and print the 4 attached documents contained within the two links provided on this page

ii. Review and complete all four documents with your personal information.

iii. Sign and date all documents where indicated.

iv. Retain these documents and provide to the concierge pharmacist during your first visit as scheduled.

v. Should you have any questions or concerns, do not hesitate to contact Medication Therapy Management Services for assistance. Under contacts see how to contact us.

Patient History Form v1

Client Consent Forms v1