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HIPAA Form

This form is required for all clients first visits, those with more than a 3 month (90 day) gap between visits, and annually in January.

HIPAA Form

The form link on this page takes you to a google document.

Download the document or print. Complete the document by hand or in Adobe Reader use the Add Comment (bubble tool below the arrow select tool). From the Add Comment drop down select the Add Text Comment tool. Place the cursor on the line you need to complete and begin typing. Do this for each line of information required.

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