NEW CLIENT REGISTRATION PACKET
- New Client Registration Packet
- Couples: please complete & sign separate packets.
- Children 13+ and clients who would like statements sent to their parent and/or guardian for payment: please sign our Release of Information (ROI) for BILLING ONLY authorizing Emmaus to release information ONLY as it relates to billing & statements.
Please print, complete, sign and bring the intake paperwork to your first appointment. If you have not had a chance to complete and sign our paperwork, please arrive 15-20 minutes prior to your appointment to complete in our office.