Policies

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Before Your Visit

Before being treated each client MUST HAVE filled out and turned in the following forms:

  A) Patient Information

  B) Informed Consent Signature Page

  C) HIPPA Signature Page

Insurance Verification

If you would like me to verify coverage with your insurance company please submit the Insurance Verification Form to me before you schedule your appointment. 

PLEASE DO NOT EMAIL ME YOUR FORMS!!

Due to the unsecured nature of email and the potential of exposure of your health information to the worng parties please wait to hand in your paperwork at your first appointment.

Minor Clients

As per California law, I need BOTH parents signature of authorization to treat any minor (17 years age or less) OR a copy of legal documentation authorizing one parent to make sole medical decsions.

Forms

Insurance Verification (pdf)

Download

HIPPA (pdf)

Download

Informed Consent (pdf)

Download

Patient Information (pdf)

Download

Release of Information (pdf)

Download