Envision Therapies
Forms
Please review, fill out, and return these forms before meeting for the first time.
Client Data
required
Office Policies & Agreement
required
Intake Questionnaire
required
Billing Authorization
required
These disclosures are for your reference. There's no need to return these to the office.
Notice of Privacy Policies
Professional Disclosure
This release of information form is helpful for coordinating care with primary care providers, medication prescribers, previous therapists, or other people that may be involved in treatment.
Release of Information
If you are planning to pay out pocket (without billing insurance), this form also requires your review
Good Faith Estimate
If you have any questions about the paperwork, your welcome to call
(206)4
7
3
-
2435
or
send an email
.
