Clinic Forms

Policies, Procedures, and Forms

On behalf of the staff at Unified Therapy Services, we are pleased to welcome you to our clinic!

Below you will find various forms, policies, and procedures. If you are a new patient, please complete the necessary forms as part of our intake process. This information is vital for our team to ensure optimal treatment outcomes. You may submit the completed forms at your next appointment.

Thank you for choosing Unified Therapy Services. We look forward to working with you!

*Requires Signature

Adult Attendance Guidelines

Pediatric Attendance Guidelines

Adult New Patient Paperwork

Pediatric New Patient Paperwork

HIPAA Notice of Privacy Practices

Acknowledgement of HIPAA*

Telehealth

Winter Weather Procedure

Provider Fillable Referral Form

Financial and Reimbursement Policy

The required Unified Therapy Services forms are designed in compliance with patient privacy and confidentiality guidelines established by the federal government.