Downloads

Accepted insurance list (pdf)

Private Pay Rate (pdf)

Super Duper caseHistory updated (docx)

HIPAA email risk form (pdf)

Adult medical history form (docx)

CHILD ONLY Emergency and authorization for pick up (docx)

Release of Records Authorization (docx)

Release of Insurance Information form (docx)

HIPAA notice of privacy practices (docx)

Consent to Treatment & Billing Agreement (docx)

good-faith-estimate-notice (pdf)