Renewed Hope LLC

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Patient Registration

Help us get to know you better so we can provide the best care possible.

Required Forms

New and returning patients are required to complete these forms prior to your first appointment.

Consent & Release Form

Secure your privacy and authorize care with our digital consent forms.

Consent Form

HIPPA Acknowledgement

Ensuring your health information remains secure and confidential.

HIPPA Form

Insurance Verification Form

Ensuring you get the most out of your coverage from day one.

Insurance Form

Medication Consent Form

Essential information regarding your treatment plan and prescriptions.

Medication Form

Patient Intake Sheet Form

Complete your intake securely to begin your path to wellness.

Sheet

Payment Agreement Form

Clear information regarding our billing, insurance, and payment policies.

Agreement Form

Policies & Procedures Form

Our commitment to your care, privacy, and professional standards.

Policies Form

TelePsych Consent Form

Simple authorization for your secure virtual therapy sessions.

TelePsych Form