Policies, Documents, and Forms

  • Policies and Consent to Treatment

    This document is comprised of three sections:
    1) office policies and financial agreement,
    2) HIPAA privacy policy, and 3) consent to treatment.

  • Notice of PRIVACY PRACTICES

    This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

  • OFFICE and FINANCIAL POLICIES

    This notice describes policies regarding billing, insurance, late fees, and cash payments.

  • Patient Authorization to RELEASE HEALTH INFORMATION

    This notice allows for the requesting of health information be exchanged between the parties specified.

  • New PATIENT Intake

    This document should be completed by all new patients prior to first appointment.