Forms
If you are a new patient with Wild Oak Medicine, please fill out the New Patient Forms that were sent to you on Charm PHR, our patient portal system. If you need a paper copy of our forms, you may download them below.
If you have pertinent medical records, please bring a copy of them to your first appointment. Please arrive 15 minutes early to your appointment and check in at the front desk. We look forward to meeting you!!
New Patient Forms
- Consent to Treat
- Medical Release Form
- Notice of Privacy Practices (HIPPA)
- Financial Policy
- The health information form can be found under your new Charm PHR account. You should have received an invitation to open a Charm Account by email. Follow that invitation and find the health information form under "Questionnaires".
**The Health Information Form can be submitted securely using Charm PHR by pressing the submit button at the bottom of the form.
You may access the CHARM patient portal by clicking the link below.
Getting to the Clinics
Downtown Office (Monday, Thursday)
Wild Oak Medicine and the office of Dr. Jen Riegle are located inside of Flourish Integrative Health. As a patient, you will receive a code for the outside door to the building to come in a sit down in the lobby. This code will be received in your confirmation email for your appointment.
At The Airport Health Club (Wednesdays)
Dr. Riegle and Dr. Holder's office is located within the Airport Health Club. Please use the main doors. The clinic is just as you enter to the right. You may always ask the Club front desk for directions as well.