NEW PATIENT APPOINTMENT NAME: ADDRESS: HOME TEL.# BUSINESS #: Your New Patient Appointment has been scheduled for:

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1 Address: NEW PATIENT APPOINTMENT NAME: ADDRESS: HOME TEL.# BUSINESS #: Your New Patient Appointment has been scheduled for: The office is open from 8:30 to 4:30 Mondays through Fridays. For the initial visit, you need to be prepared to spend around 3 hours in the office. Approximately 1 hour of that time will be spent having an extensive history taken by Dr. Bonnet s assistant, and 50 minutes will be spent directly with Dr. Bonnet (total charge: $345). Patients 16 years of age or older will ordinarily be requested to take a self-administered psychological questionnaire, which defines a number of potential possible perceptual difficulties (charge: $20). Usually at the time of the initial visit, extensive laboratory testing is performed on blood, urine, and hair (charge usually around $550, mostly covered by insurance depending on your policy). Please bring in copies of previous laboratory testing and medical records, as background information is always useful, and sometimes makes some testing unnecessary. For children please bring a vaccination history for our records. If you are on an HMO, the office will gladly provide you with the names of studies that we need so that your primary care doctor can order them and save you on the expense. Because the hair analysis is a very important study and can give us a lot of information, it is very important that you do not color your hair prior to the appointment. Also if you are due for a haircut, we suggest you wait until just after the appointment, especially those with short hair. Usually Dr. Bonnet will suggest a number of nutritional supplements, which are available in The Vitamin Room downstairs. The Vitamin Room carries an extensive line of top- quality nutritional supplements and homeopathic remedies. Our prices are usually significantly less than a health food store. Payment is required upon completion of this visit. We do not accept insurance. Patients send claims directly to the insurance company and reimbursement is sent directly to the patients. We, of course, provide you with the necessary documentation.

2 In order to hold your appointment, we need a deposit of $ due when the appointment is scheduled. This will be deducted from the fee of the initial visit. If a cancellation is made with less than seven days notice, half of the deposit will be forfeited unless the time is filled. Also if the deposit is paid by a credit card and you cancel the entire appointment without rescheduling, a $10.00 service fee will be applied and deducted from the refund. If you have any questions, please contact the office at (215) Many of our patients are chemically sensitive and even slight traces of fragrance can be problematic, so please do not wear any fragrance (perfume, hairspray, scented conditioners or moisturizers, etc.) on the day of your appointment. See list below for common sources. You are welcome to record any session. Dr. Bonnet strongly recommends taping the second visit, as this is one in which he is interpreting a lot of the results and there is a lot of information to retain. The follow up session is 20 minutes in length (charge: $150) We are excited about working together with you and feel most appreciative of any information that you would give us to facilitate our being more helpful. Enclosed you will find a patient information sheet that you will need to complete, and bring with you to your appointment. You can also visit us on the web at: Common Sources of Fragrances Perfume/cologne Fabric softener Aftershave Soap Lotion Aromatherapy Hairspray/hair products Laundry detergent Underarm deodorant Physical contact with someone wearing a fragrance Clothes hanging in closet with perfume, coat, interior of car Anything else with strong fragrance If unsure, wash clothing with Dreft (a hypoallergenic laundry detergent) or other non-fragrance detergent.

3 Directions First check your map to see where we are and where you are. Coming from North Jersey: Take the appropriate route to get to 287 South. Take 287 South to 202 South and Somerville. Take 202 South through Flemington toward Pennsylvania. Take the last exit before the toll bridge, Route 29 to Lambertville. Follow 29 South through Lambertville towards Trenton. At the third traffic light and intersection with Route 546 turn right and cross the Delaware River into Pennsylvania. The road becomes Route 532. Continue on 532 through the four-way stop to the traffic lights at the next intersection. At this light turn left onto Taylorsville Road. We are the 4 th building on the left. Our address is 1086 Taylorsville Road. The driveway is after the 1088 sign, as our sign is after our driveway. Take a left into the driveway. Enter in the back, the office is upstairs. Coming from Central & South Jersey/ 295 North: Take the appropriate route to get to 295 North. Stay on 295 North until it eventually turns into I- 95 South. Take I-95 South into Pennsylvania. Take Exit 51-B towards New Hope. This exit puts you onto Taylorsville Road. Dr. Bonnet s Office is about 2 miles from I-95. The sign is before the driveway. Take a right into the driveway. Enter in the back and the office is upstairs. Coming From PA Turnpike: Take the PA turnpike to exit 28 (Philadelphia exit). After the exit, take Route 1 North. Follow Route 1 North until you reach I-95 North. Follow the directions from I-95 North. Coming from I-95 North: Take Exit 51 New Hope/Yardley Exit off I-95 North. At the end of the off ramp, make a left, towards New Hope. We are about 2 miles from I-95. The sign is before the driveway. Take a right into the driveway. Enter in the back and the office is upstairs.

4 Local lodging accommodations near Dr Bonnet s office: 1. Pineapple Hill 8. Aaron Burr House 1324 River Road 80 W. Bridge Street New Hope, PA New Hope, PA (Bed & Breakfast) 2. The Woolverton Inn 9. Chimney Hill Farm Estate & The Ol Barn Inn 6 Woolverton Road 207 Goat Hill Road Stockton, NJ Lambertville, NJ (Bed & Breakfast) 3. Best Western New Hope 10. Inn at Fordhook Farm Lower York Road (Rt. 202) 105 New Britain Road New Hope, PA Doylestown, PA HOPE (Bed & Breakfast) 4. Golden Plough Inn 11. Inn at Stoney Hill Rt. 202 & Street Road 105 Stoney Hill Road Lahaska, PA New Hope, PA (Bed & Breakfast) 5. Historic Lambertville House 12. Inn at the Ruins 32 Bridge Street (P.O. Box 349) 110 S. Sugan Road Lambertville, NJ New Hope, PA (Bed & Breakfast) Hotel du Village 13. The Stockton Inn Corner of N. River Road & Phillips Mill Road One Main Street (Rt. 29, River Rd.) New Hope, PA Stockton, NJ Inn at Lambertville Station 14. Holiday Inn 11 Bridge St. and the Delaware 7 South Pennsylvania Ave Lambertville, NJ Morrisville, PA New Hope Inn 15. Inn to the Woods 36 W. Mechanic Street 150 Glenwood Drive New Hope, PA Washington Crossing, PA Residence Inn 15. Holiday Inn Express 15 E. Cabot Blvd W. Cabot Blvd. Langhorne, PA Langhorne, PA Courtyard By Marriott 15. Sheraton Bucks County 5 N. Cabot Blvd 400 Oxford Valley Road Langhorne, PA Langhorne, PA Homewood Suites

5 110 Pheasant Run Newtown, PA