New Patient Paperwork

Please bring your completed new patient paperwork to your first visit or send via email to bethackermandpt@gmail.com

PatientPolicies.pdf
Adobe Acrobat document [111.5 KB]
Patient Packet.pdf
Adobe Acrobat document [109.3 KB]

As a cash-based clinic you are responsible for all payment due at the time of service. You can, however, submit to your insurance company for reimbursement as an out-of-network provider. Our insurance work sheet is available to help you ask all appropriate questions to your insurance company to see if you are eligable for reimbursement. 

PatientInsuranceWorksheet.docx
Microsoft Word document [28.0 KB]
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