Appalachian Wellness

IV Services Patient Forms

This page has the required patient forms for our IV-Nutritional Services for both New Patients & Existing Patients. Please fill out the required forms prior to each visit to our office.

We do not file with insurance for IV-Services. Payment will be expected in full at time of services rendered.

We are more than happy to provide proper paperwork for anyone filing insurance themselves.

Note: We do not accept checks. Accepted payment types include cards and/or cash.

À la Carte Services

(no prescription/referral required)

New Patient Forms

Below are the forms that should be filled out by new patients

New Patient À la Carte

Before your first visit, we require that all new patients complete our A la Carte New Patient Form. It’s online, easy, and can be done in minutes.

Est Patient À la Carte

If you’ve visited us before, please fill out our Established Patient A La Carte Services form.

Prescription Services

(requires a physician’s consult)

Miscellaneous Patient Forms

Misc forms to be used for information regarding a number of different concerns.

New Patient IV Consult

For new patients interested in IV-Services requiring a physician’s consultation/referral, please fill out our New Patient IV-Services Consultation form.

Est. Patient IV Consult

If you have visited our offices before, please fill out the Established Patient IV Services Consult Form

Appointment Scheduling

After filling out the proper forms below, IV-Services can be scheduled by clicking the link below

Appalachian Wellness

Better Health Care is Our Mission & Vision

Personalized healthcare for patients suffering with chronic illness in Western North Carolina

(828) 785-1850

rjodo@appwell.net

200 District Dr. #001, Asheville, NC 28803-0235