The therapy packet includes a 14 page intake packet, in a word doc, to fill out with your company info and logo! Look for the yellow highlighted areas to fill in your own personalized company information.

Document List:

1. Enrollment Form (Pre-Service Orientation) 

2. Insurance Information Form 

a. Copy of the front and back of Insurance Card(s)

3. Release of Confidential Information 

4. Consent to Treat and Bill 

5. Notice of Privacy Practices

6. Attendance and Cancellation Policy (sample- please add your own)

7. Patient HIPAA Awareness Agreement

8. Patient Rights 

9. Communication Agreement

10. Acknowledgement Form