New Clients

NEW CLIENT PAPERWORK

Please download and submit the following paperwork which is required to begin services with IBT.  Once you have completed all the paperwork, please follow the directions provided by your consultant regarding return of paperwork.

Please make a copy of the front and back side of your insurance card and submit with your paperwork if you will be utilizing insurance reimbursement for services.  If you are interested in our sliding scale, please submit a copy of your most recent tax return with your paperwork.

IBT recognizes that the cost of therapy may be a financial burden for families.  For this reason, we do offer a treatment scholarship to help offest the costs of therapy including insurance copays, privately funded therapy, treatment supplies, and mileage.  Please contact Kari Wold for more information.

Signature Verification Form

Policies Acknowledgement

Insurance Reimbursement Form

HIPPA Information Packet

Contract for Services