Client Forms and Practice Information
Client Forms and Practice Information
Embedded Files
Below are example forms related to Client Disclosure and Practice Policies, HIPAA and Client Rights, Surprise/Balance Billing Disclosure, and Good Faith Estimate.
For more information about the No Surprise Billing Act click here
You are entitled to a Good Faith Estimate, for more information click here
Client Disclosure and Practice Policies
Client Disclosure and Practice Policies
Client Disclosure and Practice Policies.docx.pdfHIPAA and Client Rights
HIPAA and Client Rights
HIPAA and Client Rights.docx.pdf Surprise/Balance Billing Disclosure
Surprise/Balance Billing Disclosure
Surprise Billing Disclosure.docx.pdfGood Faith Estimate
Good Faith Estimate
Good Faith Estimate.docx.pdf“If we want to create a different future, we must have the courage to look at the past.”
- Dr. Dan B. Allender
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