New Patients 


Welcome, New Patient! Here is a summary of what to expect and bring to your first appointment. We look forward to meeting you soon.

Prior to your appointment:

  • Download and complete the appropriate new patient forms below.

  • Obtain previous lab results, if any, from the last year. If you don't have a copy of your previous lab results, you can request to have them faxed to Be Well Natural medicine from your previous and/or current health provider using the Authorization of Release of Confidential Information form.

  • Send your completed New Patient Intake, Informed Consent forms, and labs via email to or via fax to 1-833-817-5943 prior to the day of your appointment.

What to bring:

  • The original paper copy of the New Patient Intake and Informed Consent forms as well a a copy of your labs as a backup in case the fax/email did not go through.

  • Any supplements, herbs, and vitamins that you are currently taking.

What to expect:

  • Cost: Please take the time to review costs here. Payment is due in full at the end of your appointment.

  • Visits include a review of health history and previous lab results, nutritional assessment and basic nutritional counseling, holistic assessment, and a foundational treatment plan. Your doctor may also recommend further laboratory testing at this time.

  • A Note about Insurance: We are NOT in-network for any health insurance plans at this time so payment is due at the end of your visit. You may submit claims to your insurance on your own; if you plan to do so, let us know so that we can provide you with the appropriate documentation. Flex Spending or Health Savings Accounts are other payment options that you may use.

  • Email/Phone Correspondence: If you are a patient, the doctors are happy to answer brief questions via email to clarify your existing wellness plan; however, if your case requires new instruction, a new prescription, case analysis, or in-depth correspondence, you will be asked to schedule a phone consult or office visit. The fee for phone consultations is prorated according to consultation time at a rate of $3 per minute with a 15-minute minimum. Payment will be taken over the phone, so please have your credit card available.

  • Cancellations and rescheduling appointments: Kindly give at least 24 hours notice. To best serve our patients who are seeking appointments, cancellations with less than 24 hours notice will be invoiced $75.


Forms for Dr. Leslie Vilensky & Dr. Natalia Pellegrino

New Adult Patient Intake (Ages 13 and up)

New Pediatric Patient Intake (Ages 0-12)

Authorization of Release of Confidential Information (if needed)


Forms for Dr. Liz Orchard, Founder

New Adult Patient Intake (Ages 13 and up)

New Pediatric Patient Intake (Ages 0-12)

Authorization of Release of Confidential Information

Healing Lyme Program Forms

New Adult Patient Intake

Authorization of Release of Confidential Information (if needed)


Please note: If we have not received your completed forms and labs at least 48 hours prior to your appointment, you will be contacted to reschedule your appointment in order to give your provider sufficient time to review your health history. 


New Craniosacral Patient Forms

New Patient Intake + Informed Consent


Current Patient Forms

Authorization of Release of Confidential Information