Patient Forms

Click to download the PDF document.

Consent for
Telehealth

Consent To
Bill Insurance

Informed
Consent

Notice of
Privacy

Office
Policies

Patient Registration Packet

This packet contains the following forms: Patient Registration Form, Credit Card on File, Informed Consent, HIPAA, and Telehealth Consent.

Patient Registration Form
Patient Information Regarding Credit Card on File Policy
Informed Consent for Assessment and Treatment
HIPAA Compliance Patient Consent Form
Telehealth Informed Consent
Authorization for Disclosure of Protected Health Information