Office Policies

We like to keep things simple. There are two policies presented here for your information

Forms

Patient Enrollment Form for families new to our practice. Please complete and return to our office.

Medical Record Release for patients transferring to another physician practice. The completed form should be returned to our office along with the processing and mailing fee as indicated on the form.

HIPAA Release Form should be completed by patients 18 yrs and over indicating what, if any, medical information may be shared with parents. The form should be returned to our office and will be scanned into the medical record.

Referral Request Form is available as a guide to help parents gather the information needed to have our staff process an insurance referral for your child to see a specialist (physicians, PTs, OTs, Speech Therapists, and Nutritionists, etc.).

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