Patient Info and Forms

New Patient Info

 
Please print out these two patient forms and bring them to your first appointment. If you have not filled them out ahead of time, please let Holly know and we will arrange for you to arrive 10-15 minutes before your scheduled time (we are not using our waiting room at this time).

>> Patient Intake Form

>> Patient Waiver

Payment and Insurance

• Insurance Plan Coverage

Holly Hamilton/Healing Pathway will provide Physical Therapy services as an in-network PT provider for: Regence Blue Cross, Premera, LifeWise, Asuris and Bridgespan. If you are choosing to utilize your insurance benefits, please let Holly know PRIOR to your session so your benefits may be verified.  Several insurances require Prior authorization which takes time. Note that several plans require that you meet your deductible before PT benefits will apply. It’s ideal for you to be aware of your coverage.

Holly will check your benefit plan prior to your first session and thus will need a your ID # and Date of birth

For out of network coverage: If you would like to submit bills to your insurance carrier to try and receive out-of-network reimbursement, you may let us know you desire a “superbill” at the start of your treatment. Note: Many plans require pre-authorization for PT services and in these cases, this option does not apply. Holly is not an active medicare provider. 

• Personal Injury Coverage

Motor Vehicle Accident coverage is accepted with an active PIP. We will do all billing for you and no copay is required.  These services will be billed at Physical Therapy rates under medical coverage.

• Self Pay

Holistic Therapy Services which combine integrative PT, massage and lifestyle medicine are offered for self-pay clients and will be paid for in-full at time of service.  At our first evaluation session, we will discuss your goals and treatment plan so that it matches your financial capacity.

To aim for accessibility while providing optimal care, out-of -pocket rates are set at a lower cost, with longer treatment times than is typical in the industry for 1-on-1 care with a Doctor of Physical Therapy/ Licensed Massage therapist with two decades experience.  Self pay rates may be viewed by following the book appointment link 

• • • New Patient Evaluation & Holistic Treatment (~90 min) 
    • Follow-up Holistic Healing Session (60 minutes)
    • Follow-up Holistic Healing Session (90 minutes)

What to expect for your session

• Arrive for your session up to 5 min early with your paperwork complete. If youd like to fill out paperwork in my office, please come 10-15 min early 
• Come through the arbor to the front door.  There is a sitting area where you will slip off your shoes and can leave your coat. 
• Washing your hands in the kitchen sink or bathroom when you arrive is appreciated
• In general for bodywork clients, showering prior to your appointment is also appreciated (on a side note, Holly has an extreme sensitivity to poison oak, so please be mindful of your clothing as well if you have been hiking).
• For air quality, there are two air filters in my office and cleaning protocols are followed.

Covid and Other Illness precautions:: If any of these questions are a YES, please call/ text Holly to check-in relative to your appointment

• Do you or does anyone living in your home currently, or have you within the last two weeks had a fever, cough, shortness of breath, loss of smell/taste, body aches, cold symptoms or unusual GI issues?
• Have you been exposed to someone who has tested positive for Covid in the last 10 days?
• Have you or someone in your household tested positive for Covid in the last two weeks.
• In general, if you are feeling sick with any contagion, its best that you reschedule…please reach out so I can support you in getting on my cancellation list for appointment openings. 

Best wishes for the health of all!

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