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    Forms

    The following forms are informational regarding your consumer rights and privacy under HIPAA laws as well the intake forms for initiation of treatment. Please click on the link below to view the accompanying form(s) attached. In the case of the intake packet for initiation of service with Richmond Restorative Therapy, these forms are available here to review as needed

     

     

    Your Rights through HIPAA: 

     

    HIPAA and Your Consumer Rights (Dept of Health and Human Services)

    HIPAA and Electronic Health Records (Dept of Health and Human Services)

    HIPAA and Information Sharing with Family/Friends (Dept of Health and Human Services)

    HIPAA Privacy Notice for Richmond Restorative Therapy Clients

    Intake Packet to Review (these are the forms you will go over and sign during your initial assessment):

    Client Intake Assessment

    Client General Information

    Consent to Bill for Services

    Electronic Communication Consent Form

    Informed Consent to Treatment