Forms

For your convenience and a most effective patient experience, here are downloadable forms to fill out prior to your first visit.

spu_therpayhipaa_form_05272016_djh-2.docx
File Size:	284 kb
File Type:	docx

Download File

---

spu_therapy_perscription_05242016djh__2_.docx
File Size:	282 kb
File Type:	docx

Download File

---

spu_therapy_permission_to_treat_minor_patients_djh_06042016_djh.docx
File Size:	284 kb
File Type:	docx

Download File

---

spu_therapy_patient_information__djh_062016.docx
File Size:	282 kb
File Type:	docx

Download File

---

spu_therapy_office_policy_05262016_djh.docx
File Size:	285 kb
File Type:	docx

Download File

---

spu_new_patient_questionnaire_0602016_djh.docx
File Size:	315 kb
File Type:	docx

Download File

---

spu_past_medical_history_06042016_djh.docx
File Size:	285 kb
File Type:	docx

Download File

---

spu_guidelines_for_attending_therapy_letterhead_05262016_djh.docx
File Size:	284 kb
File Type:	docx

Download File

---

Accepted Insurances 

Aetna
Anthem Blue Cross Blue Shield
​Cigna
ConnectiCare
Empire Blue Cross and Blue Shield of NY
Golden Rule
​Harvard Pilgrim Health
Medicare
Multiplan
Nexus
​Oxford
PHCS
​Stratose
United Health Care
US Family Health Plans
UnitedHealth One