Please complete and review the following forms: The appropriate payment policy form, the medical history form, and the cancellation policy. There is also a copy of our HIPPA policy should you choose to view it. Please contact us if you are confused about which forms you should complete.
Primary Intake Forms:
2025 Payment Policy & Consent to Treat
2025 Self Payment Policy & Consent to Treat
2025 Medicaid Self Pay & Consent to Treat
Payment Plan Agreement Forms:
Payment Plan Agreement and Credit Card Authorization Forms
Medical Release Forms:
Release of Medical Information to Good Health Physical Therapy
Release of Medical Information from Good Health Physical Therapy
