Please ensure Javascript is enabled for purposes of website accessibility
top of page
Child Physiotherapy

Forms

Canvas Jute

Informed Consent Agreement for Telehealth Services

Canvas Jute

 Consent for Telehealth Services

Canvas Jute

 Financial Consent, Payment, and Cancellation Policy

Canvas Jute

Consent for Electronic Communication
 

Canvas Jute

 Informed Consent Agreement for Treatment

Canvas Jute

 HIPAA Privacy Authorization for Use and Disclosure of Health Information

Insurance & Payment Information

WellnessPT is in-network with select insurance plans. For the most accurate information, we recommend calling our office to confirm your insurance benefits or reviewing the list of insurance providers on our website.

bottom of page