Naturopathic Doctor Agreement - Naturopathy for All
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Name of ND *
Practice Address *
Phone Number *
Email Address *
License Number *
Province of Regulation *
Please review the terms and conditions below carefully
I certify that my license is in good standing with my licensing board. Should that change, I will notify Naturopathy for All (NFA) immediately and transfer care of the NFA patient to another qualified Naturopathic Doctor.

I certify that my business insurance, CPR-HCP certification and naturopathic license are current and up to date.

I certify that I will follow all of my naturopathic oaths and principles.

I will use the funds allocated to me by NFA to treat patients referred to me by NFA and those funds can be used for treatments, supplements or lab work.

I will keep all receipts for services, supplements, lab work, etc and send them to NFA when I have reached the payment cap of $750.00.  

I will notify NFA if a patient quits treatment or has 2 missed/last minute cancels.

If treatment must be discontinued for any reason I will notify NFA.

I understand that I will only be reimbursed for my services when I have reached the $750.00 cap and treatment is complete.

If I feel that I need more than $750.00, I can write a letter explaining the reason for this to NFA. I realize that the maximum amount of donation is $1,000.00/applicant and that my letter may be denied at the board’s discretion.

I agree to the terms above *
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