Bring the following completed forms to your initial session:
- Client Information form
- Therapy Information and Agreement form
- CMS 1500 Insurance claim form (if you are planning to use insurance)
- Photocopy of your insurance card (front and back) (if you are using insurance)
If you are planning to use insurance, also bring the CMS 1500 Insurance Claim Form, having completed boxes 1-13. You may leave blank anything you are not sure how to answer. In addition, bring a photocopy of the front and back of your insurance card.
To print and fill out a CMS 1500 Insurance Claim Form, click on the link below:
http://www.fchp.org/NR/rdonlyres/BCC8F41E-50D4-426A-BA30-A916F38C68BA/0/Health_insurance_claim.pdf
