Client Documents

Client Documents

Initial Visit Paperwork

  •  Client Intake History
  •  Records Release
  •  Initial Risk Screen
  •  AHCA Consent to Deliver In A Birth Center
  •  Notice of Privacy Practices
  •  Acknowledgement of Notice of Privacy Practices
  •  Consent for Health Information
  •  HRS H-3123 Risk Assessment

Financial Paperwork

  •  Policy Accepting Insurance
  •  Contracted Insurance Companies
  •  HBC Financial Contract
  •  HBC Installment Payment Agreement
  •  Medicaid Restrictions

Media / Marketing

  •  Pediatrician List
  •  Brochure
  •  Hollywood Birth Center Tour Packet