Hyperbaric Center Patient Forms

/Hyperbaric Center Patient Forms
Hyperbaric Center Patient Forms 2018-02-10T19:41:09+00:00
Hyperbaric Patient Forms

Hyperbaric Center Patient Forms

If you are planning to visit our facility for Hyperbaric Therapy Treatment, please print the following documents and bring them with you on your first day of treatment. If you need us to mail these document to you, please let us know as soon as possible so we can get them to you in time for your first appointment.

Patient Introduction Letter

Private Policy

Patient History form

Patient Registration form

Disclosure and Informed Consent form

Receipt of Notice of Privacy Practices

Blood Sugar Disclosure

Authorization to release and payment responsibility

Off Lable Disclosure

 

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  • Acute Acoustic Trauma
  • Acute and Chronic Anemia
  • Acute and Chronic Arterial Insufficiency
  • AIDS
  • ALS “Lou Gehrig’s Disease”
  • Alzheimer’s Disease
  • Autism
  • Brain Injury
  • Bells Palsy
  • Candidas and Fungal Infections
  • Cerebral edema
  • Cerebral Palsy
  • Chemical Poisoning
  • Chronic Fatigue
  • Closed head injury
  • Colitis
  • Crohn’s Disease
  • Compartmental Syndrome
  • Cosmetic Surgery (before and after)
  • Diabetes
  • Fibromyalgia
  • Flesh Eating Bacteria
  • Fracture Repair
  • Gastric and Doudenal Ulcers
  • Headaches, Cluster
  • Heart Attack
  • Hypoxic Birth Disorders
  • Inflammatory Arthritis
  • Infections
  • Lupus
  • Lyme Disease
  • Macular Degeneration
  • Migraine
  • Multiple Sclerosis
  • Musculoskeletal injuries
  • Muycoplasma
  • Near drowning
  • Near hanging
  • Nerve injuries
  • Neurovascular compression
  • Oral disease
  • Osteoporosis
  • Parkinson’s disease
  • Peripheral nerve injury
  • Peripheral Vascular Disorders
  • Rehabilitative Care
  • Retinitis Pigmentosa
  • RSD
  • Rheumatoid Arthritis
  • Sacroiliac Syndrome
  • Scelodrema
  • Shingles
  • Silcone Induced Disorders
  • Spinal Cord injury
  • Spider Bite
  • Sports injury
  • Stroke
  • Sudden deafness
  • Surgery recovery
  • Tendon injuries
  • Venomous Snake Bites
  • Wound Healing
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