Forms & Policies « Tracy Geist Therapy Services

Please download, print, and fill out the following forms prior to coming to your initial visit:

Consent to Release or Request Confidential Information
Insurance Intake Form

This form goes into much detail about your child’s developmental and medical history. You will need to have dates, names of doctors, locations, and developmental milestones available for this form to be completed.

Clinical History & Intake Form

Please download and print the following forms to review our policies prior to your initial visit:

Acknowledgement of Receipt and Understanding of TGTS Policies
Financial Policy
Cancellation & Attendance Policy
HIPAA Privacy Policy
Media Consent/Photo Release Form