ADVANCED CLINICAL NUTRITION - Dr. D. Smith (940) 761-4045 Welcome to our Client website. It is a Secure Site (Read Footnote). For our Mobile Phone & User Friendly Visitor website go to AdvancedClinicalNutrition.Com - Over 90% Client Health Success Record; Clients in 37 U.S. States and 7 International Countries!!!
Want Results? Stop Taking The Wrong Vitamins! Best To Test Before You Buy!
NEW CLIENT - INITIAL ASSESSMENT INSTRUCTION WEBPAGE - B Step 4 - Card Payment Authorization Form
Step 5 - Two "Informed Consents"
U.S.P.S. Mail Originals of Steps 4 & 5 Within 24 Hours - Thank You!
CARD PAYMENT AUTHORIZATION FORM
IMPORTANT READ FIRST
Because the processing of your payment of our services does not include swiping your credit or debit card and then signing the payment slip in our presence, our Card Processing Company requires that you complete the Card Payment Authorization Form, which is providing your written permission for us to process your card payments.
Please note that we do not charge for services or products without your verbal approval first.
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Step 4
CARD PAYMENT AUTHORIZATION (CPA) FORM (1 Page)
Please open PDF Document to the right and print two copies.
Read, INITIAL, SIGN and FILL in blanks on this policy form and U.S. mail the signed and initaled originals of the Card Payment Authoriztion Form (1 of 3), and both Informed Consents (2 of 3 and 3 of 3) to Dr. Smith within 24 hours. Do not fax or email signed Informed Consents.
With the second copy, insert it into a one-inch, 3-ring Binder for your record-keeping.
The below "Informed Consent - Clinical Nutrition Program" provides information on what to expect from our Clinical Nutrition Therapy and the "Informed Consent - Business Policies" provides some key policy informatoin for all new clients. Other policy information can be found on the "Policies & Procedures" webpage.
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Step 5
INFORMED CONSENT - CLINICAL NUTRITION PROGRAM (1 Page)
Please open PDF Document to the right and print two copies.
Read, INITIAL, SIGN and FILL in blanks on this policy form and U.S. mail the signed and initaled originals of the Card Payment Authoriztion Form (1 of 3), and both Informed Consents (2 of 3 and 3 of 3) to Dr. Smith within 24 hours. Do not fax or email signed Informed Consents.
With the second copy, insert it into a one-inch, 3-ring Binder for your record-keeping.
Please open PDF Document to the right and print two copies.
Read, INITIAL, SIGN and FILL in blanks on this policy form and U.S. mail the signed and initaled originals of the Card Payment Authoriztion Form (1 of 3), and both Informed Consents (2 of 3 and 3 of 3) to Dr. Smith within 24 hours. Do not fax or email signed Informed Consents.
With the second copy, insert it into a one-inch, 3-ring Binder for your record-keeping.
Disclaimer: Information provided in website for nutritional educational purposes only and not for diagnosis or treatment of any medical condition, disorder or disease
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MAILING ADDRESS: P. O. BOX 4652, WICHITA FALLS, TX 76308-0652
Copyright 2004 Dr. Donna F. Smith -- .NET 8/22/18
A Word from Dr. Smith regarding this Secure Website. "I have had this website since the early 1990's. As you can see by its design, it is from an original style where the left column is the navigation bar, instead of today's contemporary websites that have a drop-down Menu. From the onset, this site has been secure from viruses and malware and still is.
You may have noticed Google is now placing a padlock icon to the left of website addresses, which can be misleading if you do not know what it means. If the padlock has a red slash across it, this means that the website is not secure for credit card processing. A red slash does not mean the website is not secure from viruses and malware. To be secure for card processing, the website requires an SSL (Secure Socket Layer) Certificate and special coding for this purpose. However, “Information only” websites, like this one, do not require an SSL because no currency is being processed through the website. Still, Google is placing the padlocks on all websites, and this is very misleading to those who do not understand their meaning.
Before the SSL Certificate and Coding, “https:/” represented websites that were SSL secure for card processing and “http:/” websites were not. However, though an http:/ website is not secure for card processing that does not mean that it is not secure against viruses and malware.
Please be assured that websites with http:/, padlocks with red slashes, and pop-up warning signs are now an "automatic" response from Google crawlers when they come across a website that does not have an SSL (i.e., does not a padlock without red slash), even if the website does not require one (like information only websites) OR the website cannot be coded for an SSL Certificate because it is an original website design from the 1990's or earlier. This website is both…it does not require an SSL because it is an information only website and it cannot be coded for SSL because of its original design; hence it will always have the red slash over the padlock. .
This website contains over 1000 educational webpages, which our contemporary websites are not designed to accommodate any more. This is why I plan to maintain this original design website from Network Solutions, who guarantees all of its websites are all virus and malware free, whether of original or contemporary design, and currently I do not provide a website that processes card payments.
