New Vision offers our client forms online so they can be completed in the convenience of your home or office.
Client rights, approach to treatment, education and experience, fee information and payment policy, confidentiality, state laws, client acknowledgement
- Forms are in PDF format or Word format. If you do not already have Adobe Reader®, Click here to download.
- Download the necessary form, complete on your computer or print and fill in the required information.
- Bring the completed form with you to your appointment.
Audrey’s Forms
- New Vision Intake and Client Forms (PDF)
- New Vision Intake and Client Forms (Word)
- Audrey Rosenfeld Disclosure Statement (PDF)
- Audrey Rosenfeld Disclosure Statement (Word)
- Consent for Telehealth Consultation (PDF)
- Consent for Telehealth Consultation (Word)
- Notification of Federal Protections against Surprise Billing (PDF)
- Notofication of Federal Protections against Surprise Billing (Word)
Drew’s Forms
- New Vision Intake and Client Forms (PDF)
- New Vision Intake and Client Forms (Word)
- Drew Thomas Disclosure Statement (PDF)
- Drew Thomas Disclosure Statement (Word)
- Consent for Telehealth Consultation (PDF)
- Consent for Telehealth Consultation (Word)
- Notification of Federal Protections against Surprise Billing (PDF)
- Notofication of Federal Protections against Surprise Billing (Word)
Alta’s Forms
- New Vision Intake and Client Forms (PDF)
- New Vision Intake and Client Forms (Word)
- Alta Swinford Disclosure Statement (PDF)
- Alta Swinford Disclosure Statement (Word)
- Concent for Telehealth Consultation (PDF)
- Concent for Telehealth Consultation (Word)
- Notification of Federal Protections against Surprise Billing (PDF)
- Notofication of Federal Protections against Surprise Billing (Word)
Jennifer’s Forms
- New Vision Intake and Client Forms (PDF)
- New Vision Intake and Client Forms (Word)
- Jennifer Hutchinson Disclosure Statement (PDF)
- Jennifer Hutchinson Disclosure Statement (Word)
- Concent for Telehealth Consultation (PDF)
- Concent for Telehealth Consultation (Word)
- Notification of Federal Protections against Surprise Billing (PDF)
- Notofication of Federal Protections against Surprise Billing (Word)