Forms and Information

 

Please select and print the appropriate form for your treatment from the list below. All pages in the form are required to receive treatment at Scott Family Health. This includes general information about yourself (or dependent) and your current condition, HIPAA privacy policy (also serving as consent to treatment in our office), a financial policy (regardless of health insurance coverage), and our 24-hour cancellation policy. If you have any questions about any part of the form, please contact our office at (970) 663-2225.

Patient Health History Form

Cancellation, Consent to Text, HIPAA (3 PACK)

Informed Consent Massage Therapy Care

Informed Consent -- Chiropractic Care

Informed Consent Class IV Laser Treatment

ACUPUNCTURE INFORMED CONSENT TO TREAT

Med Pay Form

CONSENT TO TREATMENT OF A MINOR

chiropractic