Forms/Payments

 

Patient Forms

All forms will be sent to parent/guardian and completed via DocuSign.

1.) NOTICE OF PATIENT INFORMATION PRACTICES

2.) PATIENT INFORMATION ACKNOWLEDGEMENT FORM

3.) INTAKE FORM

4.) CONSENT FOR CARE

5.) DESIGNATED INDIVIDUALS AUTHORIZATION FORM
 

Questions about billing?
Please email our billing specialist, Carol Ann at cap@movewithmept.com.

 

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