Coming in for an appointment?

Want to get a jump on the paperwork?

 

 

When you come in, you will be asked to complete the following forms. Feel free to print these and fill them out in advance. The links below are PDFS.

Client Information Form

Releases of Information:

Release of Information

Release of Info Emergency Contact

Release of Info MTM – if you are utilizing their medical transport

WHODAS –World Health Organization Disability Assessment Schedule

Consent for Payment

You will be asked to sign the following forms in person, but feel free to read in advance:

Informed Consent

Acknowledgement of Receipt of Notice of Privacy Practices

HIPAA Policy

Physicians Referral– If we are billing Medicaid