2018 advanced healing arts

pili@advancedhealingartstherapy.net

907.441.6075

                                                                                         CLIENT FORMS

 

 

for new clients, please fill out the Health Information (#1) and the Client Agreement (#2) forms below (paper clip in a circle)

for new clients seeking to bill insurance, please fill out all of the above, and there is a Referral form (#3)

that will be needed from your referring doctor for the ICD-10 code

for any insurance or billing questions, please contact my biller Jennifer Thompson: ph 907.903.2634 or email:

jennifer.thompson@arcticmedicalbilling.com

the Retrain Pain (#4) worksheet is for, but not limited to: anyone dealing with chronic pain and the worksheet frames questions in a helpful way,  for any chronic or auto immune conditions, and recovery from surgery and/or injury

PLEASE EMAIL OR FAX ALL FORMS TO:

pili@advancedhealingartstherapy.net       or      844.440.5507

            

this is an encrypted email that is HIPAA compliant, and will keep your personal information secure.

I am striving to be as paperless as possible, so would value your help with this.  If you are unable to fill pdf's out electronically, please let me know when booking, to allow for some extra time to fill out prior to your appointment

                                                                           

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