*When you arrive at my office, please have a seat in the waiting room and I will come to get you for your appointment.

For adult paperwork, please print and complete the following:
If you plan to bill insurance, please discuss this with Sari in advance of your first session.

Wellness Face Sheet

Financial Policies

**Please read Privacy Policies (Updated 9/23/13) and print a copy for your records if you wish

Privacy Practices

For Pediatric Clients (up to age 10), please print and complete the following:

Insurance section does not need to be completed on the Face sheet. If you plan to bill insurance, please discuss this with Sari in advance of your first session.

Pediatric Face Sheet

Financial Policies

**Please read Privacy Policies (Updated 9/23/13) and print a copy for your records if you wish

Privacy Practices

Sari can provide you with a master copy of a super bill with codes to submit to your health insurance for reimbursement.
If you plan to bill insurance, please discuss this with Sari in advance of your visit.

To determine if your insurance will cover Out of Network Outpatient Occupational Therapy, please contact your insurance company to gather the information on this form:

Insurance Verification

Payment is required at time of service with insurance reimbursing directly to the client.

Cash-pay Wellness visits cannot be submitted to insurance.

Please contact Sari with questions: Sari@sarihands.com