MA Fee For Service
Online Therapy Consent Template
Create an online therapy consent form to gather patient consent. Sign and fill out on any device. Drag and drop to fully customize. No coding knowledge required.
Patient Medical Record Template
Medical History Record PDF template lets you collect the patient's data such as personal information, contact information in an emergency case, general medical history. By using this sample, the doctor ensures the patient's better care and treatment.
Insurance Waiver Template
Create an insurance waiver for employees declining insurance coverage. Works great on any device. Easy to customize and share. No coding knowledge required.
Patient Confidentiality Agreement
Create a signable patient confidentiality agreement. Fill out and sign with ease on any device. Drag and drop to customize. No coding knowledge. Save as a PDF.
HIPAA Release Form Template
HIPAA (Health Insurance Portability and Accountability Act), also known as Public Law 104-191, is a law passed in the United States that protects and safeguards the privacy of medical information and has two main purposes: First, to provide continuous health insurance coverage to workers who switch jobs or lose their jobs; Second, is to standardize the electronic transmission and transactions for security and protection of information. This law was primarily passed due to proliferation of data breaches concerning health information.This HIPAA Release Form PDF Template is a standard release authorization form for disclosure of health information for healthcare and health insurance providers which the subject or person consents on disclosing his health information to a certain healthcare organization. This HIPAA Release Form PDF Template is easy to modify and flexible to use.
Pregnancy Verification Template
Verify the pregnancies of your clinic’s patients easily. Drag and drop to customize your form. Send out copies. Works on desktop, tablet, and mobile devices.
These templates are suggested forms only. If you're using a form as a contract, or to gather personal (or personal health) info, or for some other purpose with legal implications, we recommend that you do your homework to ensure you are complying with applicable laws and that you consult an attorney before relying on any particular form.