Before we get started, please complete this comprehensive Intake Packet and submit it at least 1 week before your appointment so that Dr. Gussak can take the time to prepare for you. This will take 45-60 minutes, depending on complexity of the case. Please use a desktop site, not a mobile app. Do not worry about downloading the Healthie App.
You may skip anything not required, if it does not apply to you, or if you have already filled it out somewhere else. For out of state clients, please substitute the word "patient" with "client".
Healthie is the electronic medical records system we use. This is where uploads, documents, and electronic notes are kept. You can also use this platform to chat with the office. We recommend having you add Roots & Rivers Naturopathic Medical Center <yourprovider@gethealthie.com> to your address book.
Fullscript - This is the name of our Online Dispensary where you can buy products and also see your treatment plans. you will get a link to this after our first appointment together.
We encourage you to bring any medications, supplements & labwork with you to any appointments.
E-email: Office@RootsAndRivers.Health
Phone: (509)537-3660
Fax: (833)390-1316
In Love & Service,
Dr. Maria Luisa Gussak N.D.
HIPAA Privacy Practices Agreement (pdf)
DownloadTelehealth Informed Consent (pdf)
DownloadCancellation & Financial Agreement Updated 07.2023 (pdf)
DownloadConsent To Treatment & Code of Conduct (pdf)
DownloadPHQ-9 Depression Screen (pdf)
DownloadEMF Sensitivity Screen (pdf)
DownloadIFM Toxin Exposure (pdf)
DownloadGAD-7 Anxiety Screen (pdf)
DownloadRR Patient Intake (pdf)
DownloadClient Testimonial Waiver (pdf)
DownloadGood To Know (pdf)
DownloadRoots & Rivers Naturopathic Medical Center
Dr. Maria Luisa Gussak - Naturopathic Physician & Medical Director
5 S. Wenatchee Ave Suite #301 Wenatchee, WA 98801
P: (509)537-3660
F: (833)390-1316
Naturopathic Doctor, licensed and insured in Washington state. Holistic & Natural Medicine Consultant. Copyright © 2022 Roots & Rivers Naturopathic Medicine - All Rights Reserved.
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