In an effort to save time, you are welcome to download these forms, fill them out at home and bring them with you to your first appointment. If you do not have the capability of downloading the forms, hardcopies are available at the office. I just ask that you arrive 10-15 minutes prior to your appointment in order to complete the forms. This will allow us to start your appointment on time. The LFI-New Client Packet needs to be filled by EACH person being seen not one packet per couple/family. The HIPAA policy signature is at the very end of the packet. You only need to return the signature page. While this may seem like a lot of information, you only need to fill this out once. Thank you in advance for filling out the forms completely.
Below you will find the HIPAA policy for your review. There is no need to return the packet to me. The only item I need signed regarding HIPAA is already in the New Client Packet.
If you plan to utilize your health insurance, please make sure you review the insurance tab for more details regarding insurance. EACH person being seen will need to complete the LFI-Insurance Financial Policy. Email the completed LFI-Insurance Financial Policy, copy of your insurance card and driver’s license (to prevent fraud) to firstname.lastname@example.org at least 24 hours prior to your appointment so that your benefits can be verified. Please send a PDF not pictures.
LFI – Insurance Financial Policy