Forms

All forms must be received prior to scheduling appointments and/or initiating services.  Forms with computer-generated signatures will not be accepted.

• Client Information Form  (required)

• Case History Form  (required)

• Health Insurance Portability and Accountability Act (HIPAA-Privacy Rights) (keep for your files)

• HIPAA Acknowledgment Form  (required)

• Credit Card Authorization Form   (required- all information must be completed)

• Release of Information Form  (required if you want us to share/exchange information with another professional/agency)