Here are the 6 new patient registration forms that I will give you to fill out in the waiting room 15-30 minutes before your first appointment ~ if you wish, you can feel free to instead print them out & complete them at home prior to your first appointment:
(1) Patient Registration Form
(2) Consent to Treatment Form
(3) HIPAA Notification Form
(4) HIPAA Acknowledgement Form
(5) Consent To Release Information Form
*this form is optional*
(6) Good Faith Estimate Form
I am an out-of-network provider. If your insurance provides out-of-network benefits, you may be able to receive partial reimbursement from your insurance company for the fees you pay me for your treatment. I have created this form (see below) to outline the most important questions you should ask your insurance company to better learn about your out-of-network benefits. You may wish to call your insurance prior to your first appointment with me to verify your out-of-network insurance coverage.