Forms
Physical Therapy Forms: Medical Screening/Intake Form HIPAA Notice of Privacy Regulations Appointment Cancellation and No-Show Policy Billing Policy and Fee Schedule 2008	Fitness Forms: Village Fitness Membership Application Consent to Participate Form Electronic Payment Authorization Form (required for EFT memberships only) Membership Freeze Form (EFT and 12-month memberships only) Membership Terms and Conditions Recommended but optional: Physician Clearance Form New Member Fitness Survey Form Preferred Care Trivantage Reimbursement Form