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Individual Adult Forms

Individual Adult Forms

Complete the Patient Fusion online check-in before you print these forms. You must complete the online check-in at least 48 hours before your appointment for the information to be received in time for your appointment. 

After completing the Patient Fusion online check-in print out and complete the Individual Adult Forms by selecting Policies, Benefits, Contract, Adult, CCSM at the bottom of this page. Bring these forms with you to your first session along with identification (driver's license or government ID) and health insurance cards. 

Printing Help

A link to the forms is at the bottom of this page. Click on the form's name to open it directly, then print it out. Or click on the downward arrow to the right of the form's name to download it. Then open the form, and print it out.

If the forms do not open automatically you may need to download and install the program Adobe Reader here. Adobe Reader is a free program.  

If the forms do not look properly formatted on your screen, try downloading the forms to your computer, then opening them with Adobe Reader to print.

If you prefer, you may request the forms to fill out at the time of your visit. Arrive 30 minutes before your appointment to allow sufficient time to complete the forms. 
Frank Diak,
Apr 18, 2017, 11:57 AM