Intake Forms
Intake Forms
Please complete and email the intake paperwork prior to your first appointment to alarusdocuments@gmail.com. You may also print and bring the completed forms if you are unable to email them.
If you are unable to complete the forms at home, please arrive 30 minutes prior to your appointment to fill them out in the office. Thank you!
Alarus Healthcare, LLC wants you to be aware of your rights as a client and asks for your informed consent to receive treatment.
Admission Agreement-Informed Consent
Authorization for release of information in case of injury or illness at the office.
Release of Information for Emergency Contact
Alarus Healthcare, LLC wants you to be aware of your rights as a client and asks for your informed consent to receive treatment via telehealth/virtual services.
2021 Telehealth Informed Consent
Alarus Healthcare, LLC strives to accommodate for every client’s schedule- with this form, we can set your appointment confirmation to your preferred method.
Appointment Reminder Preference Form
This form will help your clinician get an overall picture of your situation.
Adult Family History
Child-Adolescent (Under age 15) History
Alarus Healthcare, LLC gives you this notice that describes our legal duties and privacy practices.
Privacy Notice
Explanation of insurance practices within our office and patient financial responsibility.
Assignment of Benefits