1. General Patient Intake Forms

• Patient Registration Form
• Medical History Form
• Financial Disclaimer for Cash-Pay Service (notifying patients we do not accept insurance)
• Insurance Waiver Form (acknowledgment of no insurance billing)

2. Informed Consent Forms

• General Informed Consent for Treatment
• Telemedicine Consent Form
• IV Therapy Consent Form
• Add-On Consent for IV Therapy
• Consent to Share Healthcare Information with Collaborating Physicians
• Mental and Behavioral Health Assessment Consent
• Alternative Therapy Consent (e.g., peptide therapy, low-dose immunotherapy)

3. Financial and Payment Forms

• Direct Pay Agreement (for cash-pay services)
• Financial Responsibility Agreement
• Payment Authorization Form
• Credit Card on File Authorization (optional)
• Cancellation and No-Show Policy

4. Medicare and Medicaid-Specific Notifications

• Medicare/Medicaid Disclaimer Form
• Medicare Private Contract Agreement

5. Privacy and Compliance Forms

• Notice of Privacy Practices (HIPAA)
• Acknowledgment of Privacy Practices
• Binding Arbitration Agreement

6. Prescription Refill Guidelines

• Prescription Refill Policy (recommending pharmacies fax refill requests to the office)

7. Controlled Substance Agreement

• Controlled Substance Agreement (for controlled medications)

8. Office Membership and Service Agreements

• Office Membership Agreement
• Health Coach Services Agreement

9. Specialized Consent and Waiver Forms

• Fitness Activity Consent and Waiver
• Allergy and Dietary Restrictions Form
• Supplement and Medication Disclosure Form
• Post-Treatment Care Acknowledgment
• Minor Consent Form
• Advanced Directive Form

10. Telemedicine-Specific Forms

• Telehealth Guidelines Acknowledgment
• Technical Requirements and Support Form

11. Diagnostic and Follow-Up Forms

• Symptom Tracker and Follow-Up Form
• Lab Testing and Results Release Form

12. Special Privacy and Media Forms

• Media and Testimonial Release Form
• Emergency Contact and Authorization to Share Information Form

13. Physician Referral Form

• Physician Referral Form (for external physicians to refer patients to our practice, with fields for the referring physician’s details, patient information, reason for referral, and relevant medical history or notes)

14. Verification of ID and Submission Form

• Verification of ID and Submission Form (allows patients to securely submit a photo ID for identity verification, with secure upload options and acknowledgment of data handling)

15. Consent to Receive Communication

• Consent to Receive Text, Email, or Phone Communications (provides patients with the option to consent to communications through text, email, or phone for appointment reminders, billing, and follow-ups)

Additionally, if we offer packages or ongoing programs, a Program Enrollment Agreement could be useful to cover terms, duration, costs, and consent for enrollment. Also, consider a Patient Portal Enrollment Form for practices offering online access to records or communication.

Please ensure these forms are easily accessible and fillable on the website, with secure submission options to maintain HIPAA compliance.

Thank you! Let me know if you have any questions or need further details.