Client Paperwork
Welcome to Mind & Motion! To get started, please print and fill out the necessary paperwork before your first appointment. Bring the completed forms with you to ensure a smooth and efficient visit. We look forward to seeing you soon! *Note- If you have filled out the paperwork through the client portal, you do not need to fill out this paperwork.
Electronic Communications Consent
This provides essential information about electronic communications, including phone calls, SMS messaging, and emails. It outlines the expectations and responsibilities between you and your provider.
HIPAA
This form includes information to help understand your rights regarding your protected health information, your rights, and how Mind and Motion, PLLC works to maintain your protected health information.
Informed Consent
& Office Policies
This document outlines our office policies and expectations to ensure a smooth and respectful experience for our clients. We prioritize clear communication, confidentiality, and mutual respect. Please take a moment to review these policies, as they help us maintain a professional and supportive environment.
Client Registration
For this paperwork, be prepared to fill out background information, medical history, and insurance information.
Release of Information
This form is to allow your provider to talk to others such as doctors, psychiatrists, or family members. It is used to coordinate care for the individual. It is valid for one year and can be revoked at any time.
Court Fees
This form only needs to be signed if you are currently or plan to be involved in court proceedings.
The Breakroom
Consent
The Breakroom is our sensory room! This form only needs to be signed if you or your child use The Breakroom at Mind and Motion.