The forms you will need are posted below for your convenience.
Please complete and print out the appropriate forms.
Remember to bring them to your appointment. You also have the option to scan signed forms and e-mail to info@1alliancecps.com or fax signed forms to 866.907.3948.
Thank You!
New Client Forms:
Client Information | |
Client Services Agreement and Consent for Treatment | |
HIPPA NOTICE FORM | |
Release of Information | |
Credit Card Authorization Form |
If you have any questions regarding these forms please contact us at 678.310.6631 in GA, 336.567.3001 in NC, or email us at info@1alliancecps.com