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: 

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

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

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

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HIPAA Privacy Notice for Richmond Restorative Therapy Clients

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

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Client Intake Assessment

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Client General Information

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Consent to Bill for Services

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Electronic Communication Consent Form

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Informed Consent to Treatment

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Credit Card Authorization Form

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For Reiki Only:

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Reiki Intake Form

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