Private Practice Clinic Forms: The Complete Set

25+ Lawyer-Approved, Professional-Looking Customizable Forms To Protect Your Private Practice

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When you purchase The Complete Forms, you get access to TWO sets of forms.

The "Essential" Forms and the "Advanced" Forms:

The 10 Beginner Forms:

  • General Acknowledgement of Forms
  • HIPAA Notice (aka Notice of Privacy Practices)
  • Acknowledgement of Receiving HIPAA Privacy Notice
  • Intake / Case History Form (Pediatric)
  • Intake / Case History Form (Adult)
  • Attendance Agreement / Cancellation Policy
  • Consent For Services Form
  • Attendance and Record of Payment
  • Payment Policy
  • Record of Contacts
  • Payment Policy and Fee Schedule
  • Record of Client Contact

The 15+ Advanced Forms:

  • Progress Report
  • Progress Note
  • Consent for Exchange, Obtain or Release of Information
  • Health Insurance Verification Form
  • Screening Permission Form
  • Communication Preference Form
  • Consent for Observation
  • Release of Photographs / Videos Form
  • CMS1500 Form (Medicare)
  • Credit Card Authorization Form
  • Acknowledgement and Assumption of Risk
  • How Did You Hear About Us?
  • Client Testimonial Permission Form
  • Physician Referral Form
  • Superbill (JUST ADDED!)

Your Instructor

Jena H. Casbon, MS CCC-SLP
Jena H. Casbon, MS CCC-SLP

Jena H. Casbon, MS CCC-SLP is a Speech-Language Pathologist and private practice consultant in Boston, MA. By day, she treats adult survivors of stroke and traumatic brain injury. After hours, she teaches regular clinicians how to start their own private practices by treating their own private clients "on the side."

She is the founder of The Independent Clinician author of The Guide to Private Patients and The Guide to Creating a Web Presence for Your Private Practice.

Course Curriculum

Available in days
days after you enroll
  Additional Forms
Available in days
days after you enroll

Frequently Asked Questions

What if I am unhappy with the forms?
I would never want you to be unhappy! If you are unsatisfied with your purchase, contact Jena immediately and she will give you a full refund.
How long do I have access to the forms?
How does lifetime access sound? After enrolling, you have unlimited access to these forms for as long as you like - across any and all devices you own.

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