Alliance Health Partners offers our patient form(s) online so they can be completed in the convenience of your own home or office.
- If you do not already have AdobeReader® installed on your computer, Click Here to download.
- Download the necessary form(s), print it out and fill in the required information.
- Email or fax us your printed and completed form(s) or bring it with you to your appointment.
Document Name |
Download |
Description |
Personal Injury (PI) Paperwork |
New patient forms for auto accident/personal injury patients |
|
General Insurance (GI) APS Paperwork |
New patient forms for Medicare or BCBS patients |
|
General Insurance (GI) Paperwork |
Download |
New patient forms for health insurance patients |
Personal Pay (PP) Paperwork |
New patient forms for personal pay/no insurance patients |
|
Workers Compensation (WC) Paperwork |
New patient forms for workers compensation patients |
|
Independent Medical Examination (IME) Paperwork |
New Patient forms for IME referrals |
|
Functional Capacity Evaluation (FCE) Paperwork |
New patient forms for functional capacity referrals |
|
Range of Motion (ROM) Paperwork |
New patient forms for range of motion referrals |
|
Notice of Privacy Practices |
A written notice of all privacy practices used in our office, as required by HIPAA |
