Insurance/ Sliding Scale Forms

Client Information Sheet: http://media.virbcdn.com/files/24/bca038ddc411ee9c-01_Insurance-InformationSheet.doc

Facilty Feehttp://media.virbcdn.com/files/36/63c859212ace9658-02_FacilityFeesFormFinal6-16.docx

Missed Appointment: http://media.virbcdn.com/files/6a/d89a732b825521a6-03_Missed-CancelledAppointmentPolicy.doc

Client Rights: http://media.virbcdn.com/files/98/d4d55442c9168ee2-04_ClientRights09-27-17.doc

Grievance Form: http://media.virbcdn.com/files/ac/32ef93a5687f16df-05_GrievanceProcedureForm.doc

Questionaire: http://media.virbcdn.com/files/ba/3616c3966bed8188-06_QuestionnaireOfficial2-6-07.rtf

We thank you for taking the time to fill out our forms prior to your appointment. Please print forms to bring with you to your scheduled session as well as your insurance card. 

If you have any questions please call our office at 208-922-9001.