Forms

New Patient Forms (Required for Medical Advocacy Clients)

Release of Information Forms

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Patient Onboarding Form
Complementary and Alternative Treatments Sheet
Emergency Contact Form
Reimbursement Schedule
Notice of Privacy Practice
General HIPAA Release
Release of Information Consent
Obtain Information Concent
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Durable Power of Attorney for Healthcare Decisions
General Consent for Medical Advocacy and Care Coordination
Information and Disclosure

Contact Me

Do I believe in accidents? Maybe. In any case, I am so grateful you stopped by this page. I will be taking on new case requests as I can -- in true Silicon Valley spirit, I hope to continue to scale up this social impact project so as to never need turn away anyone in need. Thank you for your interest.

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If you are being referred to our dry lab from a physician who feels Sophia would be best suited for your needs, please have your physician's office call us directly.

Phone: (425) 961-3003
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Fax: (425) 955 9556
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SNAIL MAIL:

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ATTN: Armadyllo-Audive-Bandbazaar,  Manos Accelerator at Google Developers Launchpad, 189 W San Carlos St, San Jose, CA 95113, USA

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CREDIT:

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© 2019 by Armadyllo QData Commons Free Rare Disease Advocacy and Care Coordination. Designed and maintained by the Webmaster, Dr.h.c Sophia Boettcher, BSc, RH (AGH), DD.

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SAFETY:

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Please note that Armadyllo provides this information for the benefit of the rare and ultra-rare disease community. All information presented in this website is intended for informational purposes only and not for the purpose of rendering medical advice. Patients must rely on the personal and individualized medical advice of their qualified health care professionals before seeking any information related to their particular diagnosis, cure or treatment of a condition or disorder. Furthermore, statements made on this website have not been evaluated by the Food and Drug Administration. The information contained herein is not intended to diagnose, treat, cure or prevent any disease.