Please arrive for your first appointment 15 minutes early for check-in and insurance verification. Download, print, and complete the applicable forms to bring to your first appointment. Descriptions of the forms are also provided below.
NEW PATIENT PAPERWORK FORMS:
- Medical History Form – This form must be completed by all new and returning patients. It gives us important information that your therapist needs to develop a treatment plan for your therapy.
- Medication List Form – Provides us with information on medication name, dosage, reason for taking, frequency, and how it is taken. This is important for your therapist to know in developing your treatment plan.
- HIPAA Form – This form describes how the health insurance information that you provide may be used and disclosed. This is required by the Health Insurance Portability and Accountability Act of 1996.
- Medicare Cap Information Letter – This is informational only, and does not require a signature. It describes the annual financial limit (cap) on therapy services that Medicare has in place.
- Consent For Minors – OSI requires that a parent or legal guardian accompany any minor children to their medical appointment. If a parent is unable to accompany a minor child to an appointment, the parent or legal guardian must sign this form.