Patient Forms The following forms and corresponding instructions have been provided for your convenience. Please note that these forms may not be the appropriate forms for all patients in all circumstances. New Patient Registration No Show & Cancellation Policy Financial Assistance Form Price List Information Recovery Group Uninsured/ Non-Covered Assistance ACA Non-discrimination Notice Notice of Privacy Practices Good Faith Estimate Rights & Protection Against Surprise Medical Bills Individual Service PlanClient Signature Individual Service PlanParent/Guardian Signature Additional Resources 4C Health Discharge Outreach letter 4C Health Physical and Medical History Form
