ATHLETE DOCUMENTS

ATHLETE INTAKE FORMS
1. 
ATHLETE Participation and Health History Form
2. 
General Liability Waiver


ITEMS TO BRING TO YOUR FIRST VISIT
1.  Identification Card (Driver's License, Student ID, or Passport)
2.  Completed ATHLETE Intake Forms



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PATIENT DOCUMENTS
PATIENT INTAKE FORMS
1. 
Patient Welcome Packet contains:
  • Patient History
  • Patient Missed Appointment Policy
  • Financial Office Policy
  • Financial Responsibility and Assignment of Benefits Policy
  • Patient Acknowledgement of Privacy Practices
  • Patient HIPAA Consent Form
2.  Advance Beneficiary Notice (ABN) - Medicare only  (select option 2)

ITEMS TO BRING TO YOUR FIRST VISIT
1.  Identification Card (Driver's License, Student ID, or Passport)
2.  Insurance Card
3.  Completed Patient Intake Forms.