Forms

Getting Ready for Your First Visit!

We are so pleased you are joining us!  Just a few quick forms and you'll be all set to receive services!

  1. Complete the Initial Client Information Form below
  2. Sign the Terms of Therapy and Release Forms below​
  3. Send us a copy of your insurance card(s)

1. Initial Client Information Form

Before you begin, please have your insurance cards, Medicaid number and physician information handy!

CLICK HERE TO BEGIN

2. Release Forms and Terms of Therapy Agreements

Click the Yellow Arrow on the left and our form will step you through each place you need to sign. So Easy!  Once you complete the form, you will receive an email to confirm your signature. Please be sure to complete this last step to submit your form to us. A copy of your completed form will also be emailed to you!

3. Send Insurance Card Copies

Email us a copy of your insurance card(s)!

Additional Forms and Tools

Prescription Form

We will be happy to request a prescription from our physician prior to your visit. If you would prefer, you can download our prescription form and share with them on your next visit!

CLICK TO DOWNLOAD

HIPAA Information

Curious about how we protect your private health information?  Here's the formal document describing our policies.

CLICK TO DOWNLOAD

Telepractice Assignments

Current patients who would like to take advantage of our telepractice services will need to sign these agreements. Click here to sign online!

Existing Patient Updates

We want to be sure we stay up to date with our current families. Please use the link here to update your information so we can reach you easily, locate your physician, handle your insurance and understand your current service needs!