Forms

Notice of Privacy Practices
All Services

Notice of Privacy Practices.pdf

Release of Information Request
Reciprocal Authorization for Release

PHI Release PDF.pdf

Informed Consent for Therapy
All Therapy Services

Informed Consent for Therapy Revised Feb 2022 PDF.pdf

Animal Assisted Therapy Notification
Animal Assisted Therapy

Animal Assisted Therapy Notification PDF.pdf

No Surprises Act
Disclosure Notice Regarding Surprise Billing

Disclosure Notice Regarding Patient Protections Against Surprise Billing PDF.pdf

Surprise Billing Protection Form (Sample)
Notice and Consent Documents Under the No Surprises Act

Surprise Billing Protection Form Sample.pdf