New Patient Center
Everything you need to get started as a new patient at Tri-State Healing Initiative. Complete your intake and consent forms before your first visit — securely through Tebra's HIPAA-compliant patient portal.
Your Path to Your First Visit
Follow these four steps to complete your new patient onboarding before your appointment.
Book Your Appointment
Schedule your first visit via our Tebra patient portal — in-person or telehealth.
Complete Intake Form
Fill out your medical history, current medications, symptoms, and insurance information.
Sign Consent Forms
Review and sign your treatment consent, HIPAA privacy notice, and telehealth consent.
Attend Your Visit
Meet with Dr. Ratliff for a comprehensive, root-cause focused consultation.
Patient Intake Form
Please complete this form before your first appointment. Your responses help Dr. Ratliff prepare a comprehensive, personalized care plan.
HIPAA-Compliant & Secure
All information you provide is protected under the Health Insurance Portability and Accountability Act (HIPAA). Your data is encrypted in transit and at rest, and will only be used for your medical care at Tri-State Healing Initiative LLC.
Personal & Demographic Information
- Full legal name, date of birth, gender identity
- Address, phone number, email
- Emergency contact name and relationship
- Preferred language and communication preferences
Chief Complaint & Current Symptoms
- Primary reason for your visit
- Symptom onset, duration, and severity
- What makes symptoms better or worse
- Impact on daily activities and quality of life
Medical & Surgical History
- Current and past diagnoses
- Prior surgeries and hospitalizations
- Chronic conditions and ongoing health concerns
- Family medical history (parents, siblings)
Medications, Supplements & Allergies
- All prescription medications with dosages
- Over-the-counter medications and supplements
- Vitamins, herbs, and functional medicine supplements
- Drug, food, and environmental allergies with reactions
Social & Lifestyle History
- Diet, exercise habits, and sleep patterns
- Tobacco, alcohol, and substance use history
- Occupation and environmental exposures
- Stress levels and mental health history
Insurance & Billing Information
- Primary insurance carrier and member ID
- Secondary insurance (if applicable)
- Policyholder name and relationship
- Preferred billing contact information
Complete Your Intake Form
Click below to complete your patient intake form securely through Tebra's HIPAA-compliant patient portal. Your information will be uploaded directly to your patient profile and available to Dr. Ratliff before your appointment.
You will be redirected to Tebra's secure patient portal.
No account required for first-time patients.
A Message from Dr. Ratliff
Watch this short welcome video to learn what to expect at Tri-State Healing Initiative and how we approach your care.
Welcome to Tri-State Healing Initiative
Dr. Ratliff's welcome video will be available here soon. In the meantime, feel free to call us at (201) 691-8180 with any questions.
Video coming soon — check back shortly.
Meet the People Behind Your Care
At Tri-State Healing Initiative, every member of our team is committed to delivering compassionate, personalized care that puts you first.
Dr. Bryce Ratliff, MD
CEO / Medical Director
Dr. Ratliff is a board-certified physician specializing in functional medicine and primary care. As founder and Medical Director of Tri-State Healing Initiative, he leads a root-cause approach to healing — combining advanced diagnostics, evidence-based medicine, and personalized care plans to help patients achieve lasting wellness across 8 states.
Taylor Ratliff
Clinical Care Coordinator
Taylor is the heartbeat of the Tri-State Healing Initiative team, serving as the primary point of contact for patients navigating their care journey. With a natural gift for communication and a genuine passion for patient advocacy, Taylor ensures every patient feels heard, supported, and guided every step of the way.
Melinda "Kay" Duke
Certified Nursing Assistant / Field Tech
Kay is a dedicated Certified Nurse Aide and skilled phlebotomist with extensive experience in patient care. Known for her compassionate approach and strong work ethic, she brings expertise in vital sign monitoring, specimen collection, patient support, and scheduling coordination to every patient interaction.
Accepted Insurance Plans
We accept most major insurance plans. Contact our office to verify your specific coverage before your appointment.
Don't see your insurance listed? Call us at (201) 691-8180 — we may still be able to accommodate you.