Williston - (802) 860-4360
Burlington - (802) 657-7990
Shelburne - (802) 985-9360

Patient Forms

New Patients

Please fill out these three (3) forms below prior to your first visit. Completing them ahead of time will allow your therapist more time to perform your evaluation.  The 4th document is an information sheet about HIPAA.  Please read this document prior to completing the authorization form.  On the day of your first appointment, bring all three forms with you in addition to your insurance cards.

 

Returning Patients

If you have not been seen this calendar year, please fill out and bring the HIPAA authorization form to your appointment along with your insurance cards.

 

Forms

Health History Form
Patient Intake Form
Authorization Form
Notice of Health Information Privacy Practices