Important Paperwork

What you need to do before your first appointment

Medical History

Below is the Medical History PDF. Please download, print, and fill out prior to your first appointment.

Health History/Medical Intake Form

Consent Form

The Consent Form PDF. Complete prior to your first appointment.

Consent Form

Medical Release of Information

Due to HIPAA and confidentiality laws, a release of information form will be signed by they client to allow Just Right at Home to collaborate with additional member of your medical and rehab team beyond the referring physicians.

Release of Information

Good Faith Estimate

Under Section 2799B-6 of the Public Health Service Act, if you are not enrolled in a health insurance plan, a Federal health care program, or are not seeing to file a claim with your plan or coverage, you have the right to receive a "Good Faith Estimate" of expected charged.

Good Faith Estimate

Other Items Required Prior to Your First Appointment

Insurance Card

Drivers License

Doctors Order

Medication List

Frequently Asked Questions

What if I am unsure if I was requested to fill out the Good Faith Estimate?

Not to worry! Any questions you have about additional paperwork (paperwork other than the Consent Form and Medical History document) can and will be addressed during your first appointment.

Is this covered by my insurance?

Yes, the occupational therapy assessment and training can be a covered service if medical necessity is determined and you have a doctors order, Just Right at Home is in-network for Medicare Part B and Blue Cross Blue Shield. If you do not have one of these providers, please consult your insurance company for their out-of-network policies. Services not deemed medically necessary will invoiced.