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mark These forms have been placed here for your convenience.






1) These forms can be viewed in your browser or downloaded to your computer.

2) To view and print from your browser you will require the Adobe Acrobat Reader plug-in.

3) To download and print you will need Adobe Acrobat Reader if it has not been installed.

4) To get and install Acrobat Reader follow the link below:

http://www.adobe.com

Print and complete the health questionnaire and HIPAA forms to bring to
first appointment.

HIPAA
Download HIPAA Notice of Privacy Practices

Health Questionnaire
Download Patient Registration Form

Accident Questionnaire
Download Personal Injury Questionnaire

Treatment Consent
Download Treatment Consent Form
Download Consent to Treat Minor Child Form

Direct Pay
Download Direct Pay Form

 

 


Disclaimer:The material in this site is provided for personal, non-commercial, educational and informational purposes only and does not constitute a recommendation or endorsement with respect to any company or product. Innovative Healing Center makes no representations and specifically disclaims all warranties, express, implied or statutory, regarding the accuracy, timeliness, completeness, merchantability or fitness for any particular purpose of any material contained in this site. You should seek the advice of a physician regarding your particular situation.

For Appointment Call

972-742-1152