- PATIENT INTAKE FORM
This form has to be filled out before your first appointment. If you are booking online you will receive a link to an online version of this form via email!
- INITIAL TREATMENT CONSENT FORM
You will be asked to sign this consent form during your first appointment. You are encouraged to read the document ahead of time and ask questions during your patient intake.
- RECORD RELEASE REQUEST
Please use this form to authorize other health care providers to release medical records to Ygeia Therapy.
- CREDIT CARD AUTHORIZATION FORM
Please fill out this form if you would like to use direct billing to a third party (incl. insurers). Authorizing us to bill amounts not covered by the third party to your credit card.
- MSP BENEFIT ASSIGNMENT FORM
Please fill out this form if you have MSP Premium Assistance Status and would like the eligible amount to be directly billed to MSP.
- TELUS-HEALTH BENEFIT ASSIGNMENT FORM
TELUS-HEALTH ELECTRONIC TRANSMISSION AUTHORIZATION & CONSENT FORM
Please fill out these two forms if you would like to direct bill to a Telus-Health Insurer.