Insurance Info & New Patient Forms
Harmony Hand & Physical Therapy New Patient Forms
- Patient Data Form: We have condensed this to one page for your convenience. Print and complete form and bring to your first appointment.
- HIPPA Notice of Privacy Practices: Information purpose only
- Medical Records Release Form: This is only necessary to complete if you need your medical records released to another person or organization.
- Prescription Form: copy and take to your physician for advice and signature if your health insurance requires a physician prescription.
- Customer Satisfaction Survey: We appreciate your feedback! Fax or mail to Harmony Hand & Physical Therapy Center, Inc.
Insurance Information
We are in network with all insurance plans except: Poudre Valley Hospital, Banner Health and Kaiser Permanente. If you do not see your insurance plan here, please call us. We may recently have contracted with your insurance company.
AARP |
Eight
Benefit Elec. FundFarmers |
Pacificare |