New Patient Paperwork

New Patients in Madison 


Please take the time to print out, read through, fill out, and sign these forms to the best of your ability. It is essential you have these ready before your appointment as treatment cannot start without them.  Plan on this taking 20-30 minutes to complete as the initial intake is quite detailed.  


Thank you!

New LENS Patients


For patients starting low energy neurofeedback (LENS) please carefully read the LENS consent form and come to your visit with any questions.

Please read, fill out, and sign the assignment of benefits form below if you plan to use your insurance for office visits. 



Dr. Schull currently accepts:

  • Anthem BCBS

  • Cigna

  • Aetna

Please read, fill out, and sign the pricing and fee policy above, this becomes important if you are not using insurance, your insurance does not cover naturopathic doctor visits, or you insurance is not one of the 3 listed to the left.

© 2013-2020 by Derrick Schull, N.D.