Paperwork & Forms

Click the links below to view and download paperwork and forms.

New Patient Intake Paperwork
 Other Forms

Notice of Privacy Policies – This explains how Synergy Healthcare can use your personal information under the limits of the Health Insurance Portability & Accountability Act (HIPPA). We are totally committed to keeping your information confidential and protected.

Prescription Form – If you need a prescription from your doctor for therapy, just print this off and have them fill it out at your next doctors appointment.

Minor Release Form – Is your child old enough to drive? Want them to be more independent? This gives Synergy Healthcare permission to treat your minor child without a parent or guardian onsite.