Register with Inspired Health: Integrative + Functional Medicine Center

Welcome to the Inspired Health REGISTRATION PAGE!

To register as a new patient, please enter your information in the form fields below.

Please do not use this form if you are already a patient (you have seen any of our practitioners in the past).

To set up patient portal access or amend your information, please contact us.

If you are already a registered patient with online access, you can log in here.

We ask that all NEW Patients REGISTER to schedule an initial appointment.

The Registration will allow you to create a username and password for your Patient Portal.

Once you have logged into your Patient Portal, we require the following forms be filled out in order to schedule:

  • All of the mandatory NEW PATIENT INTAKE FORMS located in the Questionnaires Tab

When your Intake forms are finalized, our office will contact you to set up an initial appointment!!

Prior to your initial appointment, we encourage you to look around our website, visit our Online Store, and to read up on how we work with patients.

NOTE: Our online forms are most compatible with Chrome and Firefox browsers. To avoid potential technical issues, please use Chrome or Firefox. We also recommend completing your online paperwork on a computer or laptop. Trying to complete the paperwork on a phone, iPad or tablet can sometimes be problematic for patients.

We are honored that you’ve chosen us to partner on your journey towards Inspired Health.

Basic Contact Information

Date of Birth *

Your Address

Contact Information

Contact Preferences

Emergency Contact

Insurance Information

Our office will bill your insurance(s) as a courtesy. We only bill insurances we're in network with. In-Network Insurance Companies are listed HERE
Please remember that outstanding balances not paid or delayed by insurance processing are patient responsibility and due within 60 days from date of service. We also expect patient responsibility to be paid at the time of the visit (deductible, coinsurance, copay).
If you plan on using Insurance, please fill out all mandatory fields.

We encourage you to visit our FEES & INSURANCE page for details.

Please note: our clinic is NOT in-network with any Medicare / Medicaid products - WE are UNABLE to bill for either.

As a courtesy: We will call your Insurance Company to verify benefits prior to your appointment.

However these quotes are not always guaranteed, and we recommend that YOU also call your Insurance company prior to your visit.

If you are seeing Michelle Hirschy-Baker as a patient - and you have Moda or Providence insurance coverage - she is in network with these insurance companies; however, please note that we are unable to accurately verify your insurance benefits due to the vast amount of differing plans. Please contact your insurance company to verify your benefits according to your plan and your treatment with Michelle here at Inspired Health.

Please take a moment to call your insurance company to better understand your "Naturopathic Medicine" and "Acupuncture" coverage benefits.

Medical Information

Please enter your basic medical information below. You may also add or edit this information after you've signed up.

Set Username and Password for Patient Portal

Please create a username and password that you will use to log into the patient portal in the future.

Your username must be at least 4 characters long

Your password must be at least 8 characters long and include at least one number or special character.

The patient portal gives you access to your medical records and lets you securely communicate with your doctors. When you sign up, you will receive an email with instructions for logging in.

Contact Cerbo Technical Support
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