First Visit Forms

Is this your First Visit?

Greetings!

We are very excited that you have arrived on this page! This means you are investigating ways to take control of your well being and restore the fabulous back into your life! We have two forms that will need to be completed prior to your first visit.

We are members of the Pastoral Medical Association and as a licensed Doctor of Clinical Pastoral Medicine, regulations require that the Pastoral Medical Association’s Member Services Agreement form (MSA) be reviewed and signed before the first visit for services to be provided.

Form #1

The MSA form protects your right to seek pastoral natural health services, and also our right to provide those services to you. This form may be reviewed and completed online at home for convenience.

When completing the form online you will be asked to insert the practitioner’s name, this will notify us you have completed the form. Please insert:

Practitioner name: Tanya Nodich

Click here to review and complete the MSA Form

Membership level defaults to a Free member unlimited subscription, simply click next to continue.

Welcome to the Pastoral Medical Association
and the Member Share Network

The Member Share Network is a private healthcare association where PMA licensed providers and network members come together to share safe and effective alternative health care options.

Form #2

The second form is a Nutritional Assessment Questionnaire. Please print the form and complete it. Take your time answering all of the questions as truthfully as possible. The first step to kicking your “Health” into the Quantum Field is awareness. This is a bold step!

Please bring the completed questionnaire to your appointment.

Click here to download the Nutritional Assessment Questionnaire

Pastoral Medical Association - Member Share Network

Three Good Reasons To Join PMA’s Member Share Network!

Because more and more families are seeking safe natural health care options and they want to be sure their provider is a qualified professional.

Because network members have access to a professional level of natural health options, discount laboratory testing, proven products, self care education and professional advice and assistance right in their own hometown.

Because members have access to providers from every field of health care in all U.S. States, Canada and many other Countries, plus distance consultation!

Member Share Network Licensed Providers are concerned, qualified health care professionals that take time to listen to members that want safer health care options for their families.