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Forms & Articles

 Forms

  • Intake form  Word document: allows you to fill out your intake before your visit.
  • Pediatric Intake  Word document: intake for 16 y.o. and under.
  • Release of Records  Word document: take or mail this to previous practitioners.
  • Diet diary  Excel document: often it is helpful for us to see what your typical diet is like. 
  • Hours We see patients from 9-5 Tuesday, Thursday & Friday, and Dr. Pollack is available additionally 10-3 Monday, 1-5 Wednesday, and by appointment on Saturday.  Our reception area is the Backcountry herbal Apothecary, open 10-5 Monday, Wednesday & Friday; 10-6 Tuesday & Thursday. 
  • Office Visit Codes & Fees   Excel document: Detail of insurance codes and office visit fees, which range from $45 to $260.  Expect to spend 1 to 2 hours on the initial visit, and 1/2 to 1 hour on a follow-up visit.  We participate in the "Community Care Card System", a sliding scale discount (15-75% off)  for low income families. 
  • Map Word document.  How to find us on the South side of Main St, at 1st Ave in Frisco. 
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