Clinic Check-in & PAtient Forms

Visit / Register / Check

A- Registeration

Register upon checking-in at the Clinic-Reception Desk
( Time, Name, Signature )

Receive infomercial material – pamphlets

o Energy Medicine

o Integrated Medicine

B- Pre-Visit Procedure ( Open File :

• Date/time
• Name/Sex/Birthday/city/ref.by/
  • Photo ( Face, Standing Face, Side )
• Visit-Form
  • Main Complain
• Vitals: Weight / Pulse
• Questionnaire ( Fill )

· Non-Objection Form ( Sign )

C- Collect Samples / Perform Tests if required

• Zamzam: Water Test
• Obtain Hair, Skin Samples
• Draw Blood for Testing
• Bio-Feedback Aura
•  

D- Visit ( Consultation – Diagnosis & Therapy )

E- Post-Visit Procedure

• Schedule/Log next Visit date

Satisfaction Form