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HealthONE Clinic Services Rehabilitation Quick Check-In

What To Bring With You

Thank you selecting HealthONE for your rehabilitation.

Speed up your first visit with us and spend less time in the waiting room by:

  • bringing your current insurance card
  • bringing your current signed prescription written within the last thirty days
  • printing and completing the forms below and bringing them with you.

Injured in a motor vehicle accident?
You need to bring these also:

  • Med-pay information / documentation
  • group health insurance card
  • automobile insurance card or information
  • the name of the state in which the accident occurred.

Complete and bring these forms and arrive just minutes before your scheduled appointment!

These forms are in .pdf format. If you are unable to view them you may here download the necessary free reader software from Adobe.

Clinic Policies and Welcome

Consent to Treatment

Permision Para Examinar

Medical History

Medicare subscribers only.
Medicare secondary insurance questionnaire.

Insurers We Contract With

Avoid surprises. Visit your insurance provider's site below and review your coverage on-line before you arrive for your visit.