Client Forms

The following forms must be completed PRIOR to your first appointment.

Please note that ALL TELEHEALTH clients are required to complete and return the packet prior to their first appointment. They can be faxed to 888-602-7956 or sent via regular mail. Some clients do choose to email them but please note that email does not meet the privacy standards set forth by HIPAA and by choosing to do that, you acknowledge there is a risk and that we are not able to protect this information in transit. If using this method, they can be emailed to: DrMaples@mindbodywellness.org

Forms

• Client Handbook (required)

• Privacy Practices (required)

• Privacy Consent (required)

• Client Information Form (required)

• Financial Agreement (required)

• Release of Information Form (recommended)

• Telehealth Consent (required for telehealth clients)

Questions?

If you have any questions about the forms above, please call the office at 417.216.0121