patient forms

Forms below. Download, fill out, send ahead or bring with you to your first appointment.

Naturopathic Medicine takes into consideration all aspects of your being. We take into account how you live your life day to day, where you live and the social, chemical and environmental impacts. We look at what you do and what you have tried to alleviate your current health condition. We want to know what happens with the inputs into your body - food, air, water, supplements, medications, toxins, emotions. We wish to evaluate the patterns of how you assimilate, transport, transform and eliminate all of these forms of input. This means we look at digestion, how nutrients are absorbed and transformed and how well your body's defense and repair mechanisms work. 

The totality of the information you provide gives Laura the details for her to evaluate both microscopically (see the small scale of what's going on) and macroscopically (observe the patterns the body has established in its current state). What you are unsure of, leave blank and we can go over it together. 

As a new patient, it will take about 30 minutes for you to complete the initial intake form. Please be as honest and forthcoming as you can. There is no judgment of where you are at today. You are here because you recognize there might be a better way to care for yourself. You are not your disease. You are you. With the changes and challenges life throws our way, we do the best we can with what we know at the time. 

Time with Dr. Laura M. Brown, ND will provide you better insight, education and methods to help bring you to a better level of health.

Congratulations on taking the initiate to a more healthful, natural life. 

Naturalaura Intake Form with privacy and consent

Diet Diary

Toxicity questionnaire


Insurance Claims

 Please check with your individual / group plan for your specific coverage.

Provider Coverage

Updates may be found at: 

https://www.telushealth.com/health-solutions/claims-and-benefits-management/eclaims/faq-provider

 

a) Chambers of Commerce Group Insurance Plan - YES
Expenses for the following specialized healthcare providers are supported:

  • Acupuncturist
  • Chiropractor
  • Massage therapist
  • Naturopathic doctor
  • Optometrist
  • Physical Rehabilitation Therapist (Quebec only)
  • Physiotherapist
  • Podiatrist (Quebec only)
  • Psychologist (Quebec only)
 
b) Cowan Insurance Group (managed by Express Scripts Canada) - YES
At this time, only the following healthcare providers can submit expenses electronically:
 
  • Acupuncturist
  • Chiropractor
  • Massage therapist
  • Naturopathic doctor
  • Physiotherapist
  • Podiatrist (Quebec only)
  • Psychologist (Quebec only)
  • Vision care providers (Optician and Optometrist)
The patient must manually submit all other extended healthcare claims.
 

c) Desjardins Insurance - YES
All healthcare provider disciplines are accepted (Physical Rehabilitation Therapists, Podiatrists, Psychologists are Quebec only). Note you may need to pay upfront and wait to be reimbursed direct from Desjardins shortly thereafter. Timing depends on Dejardins.  

d) Great-West Life Assurance Company - YES
All healthcare provider disciplines are supported except Physical Rehabilitation Therapists, Podiatrists, Psychologists.

e) Industrial Alliance Insurance and Financial Services Inc. - YES
The following healthcare providers can submit expenses electronically:

  • Acupuncturist
  • Chiropractor
  • Massage therapist
  • Naturopathic doctor
  • Physical Rehabilitation Therapist (Quebec only)
  • Physiotherapist
  • Podiatrist (Quebec only)
  • Psychologist (Quebec only)
  • Vision care providers (Optician and Optometrist)
Fees are accepted provided the practitioner is licensed by the appropriate provincial or federal organization to practice his/her profession in accordance with the rules of his/her profession.
If the practitioner’s services  are covered by a provincial health plan, no coverage will be provided under this benefit for the paramedical care given until the maximum under the provincial plan has been reached.  

 

f) Johnson Inc. - YES
At this time, only healthcare providers registered with TELUS Health can submit expense forms electronically: 

  • Acupuncturist
  • Chiropractor
  • Massage therapist
  • Naturopathic doctor
  • Physiotherapist
  • Vision care providers (Optician and Optometrist)
 
g) Manulife Financial - YES
Expenses can be submitted electronically for all health care provider roles that TELUS Health currently supports, except Physical Rehabilitation Therapists, Podiatrists, Psychologists..

 

h) Maximum Benefit or Johnston Group- YES
Expenses for the following specialized healthcare providers are supported: 

  • Acupuncturist
  • Chiropractor
  • Massage therapist
  • Naturopathic doctor
  • Optometrist
  • Physical Rehabilitation Therapist (Quebec only)
  • Physiotherapist
  • Podiatrist (Quebec only)
  • Psychologist (Quebec only)
 
 
i) Sun Life Financial - YES
At this time, only the following healthcare providers can submit expense forms electronically:
  • Acupuncturists (Alberta, British Columbia, Ontario, Quebec, Newfoundland and Labrador)
  • Chiropractor
  • Massage Therapists (Alberta, British Columbia, Manitoba, New Brunswick, Newfoundland and Labrador, Nova Scotia, Ontario, Quebec, Saskatchewan)
  • Naturopathic doctors (Alberta, British Columbia, Manitoba, Nova Scotia, Ontario, Saskatchewan)
  • Physiotherapist
  • Vision care providers (Optician and Optometrist)
Patients must manually submit all other extended healthcare claims.
 

j) Standard Life Assurance Company- YES
At this time, only healthcare providers registered with TELUS Health can submit expense forms electronically:

  • Acupuncturist
  • Chiropractor
  • Massage therapist
  • Naturopathic doctor
  • Physical Rehabilitation Therapist (Quebec only)
  • Physiotherapist
  • Podiatrist (Quebec only)
  • Psychologist (Quebec only)
  • Vision care provider (Optician and Optometrist)
The patient must manually submit all other extended healthcare claims.