Primary Care

• Full Circle Women's Health

Complete Health Care for Women and Teens

Lisa Gussack, RN, CNM, MS, MPH

Kathy Herron, MS, CNM
Robin Bradley, MS, CNM

Michelle Chiafulio, CM

◊Intake Form/HIPAA (new patients)

◊Medical Records Release Form (to transfer your records to FCWH when joining our practice)

◊Medical Records Release Form (to transfer your records to new provider)

◊Menstrual Chart

Childbearing Years

• Regina Camillieri IBCLC, RLC
International Board Certified Lactation Consultant

• Rosie Murtagh, IBCLC

International Board Certified Lactation Consultant

Mental Health

Clinical Psychologist

• Josephine Kuhl, MD
Child and Adolescent Psychiatrist
◊Intake Form
◊HIPAA
◊Cancellation Policy

• Bridget Rice Buckstine, LMSW

Licensed Master Social Worker

• Christina Fay, LMSW, Reiki Master

Holistic Counselor

• Mark Sirkin, PhD

Psychologist and Hypnotherapist

Specialists

• Janice Ditchek

Clinical Herbalist and Herbal Education

• Jonathan Donath, D.C., M.S.

Chiropractor and Nutritionist

◊Intake Form

◊HIPAA

• Melissa Keras-Donaghy, DPT, CLT-LANA

Women's Health Physical Therapist
Certified Lymphatic Therapist

◊Intake Form

◊HIPAA
 

• Hedi Leistner, MD

Pediatric Pulmonologist

Medical Acupuncture

◊Initial History

◊Patient Consent Form

◊Patient Information

◊Privacy Statement

Breast and Whole Body Thermography

◊See webpage for intake forms

• Neda Smith, FDN, CMTA, HHC
Functional Diagnostic Nutritionist
Metabolic Typing Advisor

◊Women's Health History Form

◊Men's Health History Form

◊Revisit Form

• Jaesun Yoo, L.Ac. MAOM, Dipl. OM

Acupuncture & Herbal Medicine

◊General Intake Form

◊Female Fertility Intake Form

◊Male Fertility Intake Form

◊Office Policy & Informed Consents Forms

Mind • Body • Spirit

• Danielle Elise Guillet, LMT

Licensed Massage Therapist

• Rebecca Shroyer, LMT

Licensed Massage Therapist