Dear holistic clinical pharmacist consultation clients.

Please read and complete the following documents:

Health and Wellness Questionnaire pdf

Consent to Care & Privacy Practices pdf

Privacy Statement
Your Consent
By using this site, you agree with the terms of this Privacy Policy. You consent to the collection, use, and disclosure of information that you may submit or that we may collect in accordance with this Privacy Policy. Further, the laws and regulations of the United States of America and the State of Ohio govern this site. Your use of this site constitutes your agreement that information collected, including any personally identifiable information you may provide, is subject to those laws and regulations only.

Active Information Collection

Like many Web sites, this site collects information from its visitors, both by asking you specific questions and by permitting you to communicate directly with us via e-mail. Some of the information that you submit may be personally identifiable information (that is, information that can be uniquely identified with you, such as your address, e-mail address, phone number, and so on).

Passive Information Collection

As you navigate through a Web site, certain information can be passively collected (that is, gathered without your actively providing the information using various technologies and means, such as navigational data collection).

A “cookie” is a bit of information that a Web site sends to your web browser that helps the site remember information about you and your preferences. (It allows you to place products in a “shopping cart” and return to the cart at a later time without losing the item(s) you selected.) This site uses cookies.

Use and Disclosure of Information

Except as otherwise stated, we may use your information to improve the content of our site, to customize the site to your preferences, to communicate information to you (if you have requested it), for our marketing and research purposes, and for the purposes specified in this Privacy Policy. If you provide personally identifiable information to this site, we may combine such information with other actively collected information unless we specify otherwise at the point of collection. We will take reasonable measures to prevent personally identifiable information from being combined with collected information, unless you consent otherwise. In addition, we will make full use of all information acquired through the site that is not in personally identifiable form.

Access to Personally Identifiable Information

To keep your personally identifiable information accurate, current, complete, please contact us. We will take reasonable steps to update and correct personally identifiable information in our possession that you have previously submitted via this site.


We take reasonable steps to protect your personally identifiable information as you transmit your information from your computer to our site and to protect such information from loss, misuse, and unauthorized access, disclosure, alteration, or destruction. You should keep in mind that no internet transmission is ever 100% secure or error-free. In particular, e-mail sent from this site may not be secure, and you should therefore take special care in deciding what information you send to us via e-mail. Moreover where you use passwords, ID numbers, or other special access features on this site, it is your responsibility to safeguard them.