Privacy Practices

Kid At Heart Therapy, LLC understands that your information is highly personal and we are committed to safeguarding your protected health information. We are required by law to maintain the privacy of individually identifiable patient health information. We will only use or disclose your protected health information as permitted or required by applicable state or federal law. Please read our Privacy Practices for details.

Privacy Practices (Online Webpage)

Privacy Practices (PDF)

HIPPA Signature Form (PDF)

Payment Policies

We are established as a participating provider with most major insurance companies. Our billing department works closely with insurance companies to determine eligibility and coverage, and will bill your insurance company directly for our services. Not all therapy services are a covered benefit in all contracts. We will gladly discuss your insurance benefits and answer any questions you may have as to the involvement of your insurance in receiving this care. If there is no insurance coverage, we will work with you to arrange payment options.

Payment Policy Acknowledgment (PDF)

Organizations exist to assist with the cost of therapy for families for whom the prospect of therapy poses the potential for financial hardship. Two such organizations include:

Family Hope Foundation
Miles for Special Smiles

Forms

Patient Intake Form (PDF)

Medical Records Release Form (PDF)

Informed Consent Forms