Forms

Colleen understands the value of your time.  For your convenience, forms are available here for you to print out and complete prior to your initial visit.  Please fill out as completely as possible and bring them with you to your first visit.  If you are unable to download these forms, Colleen will have them available for you at your initial assessment.

HIPAA PRIVACY AUTHORIZATION

HIPAA (Health Insurance Portability and Accountability Act) Privacy Authorization Form: this form is required and ensures the security and privacy of your health data.

INSURANCE VERIFICATION FORM

Please fill out personal information sections and fill out policy numbers as shown on your insurance card. Colleen can assist you in calling for verification and pre-authorization of your benefits if needed.

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