Thanks for purchasing my Practice Forms Packet, now with 24 forms!  

Below you will find the links to the forms that are part of this Packet. Click on a link, download the form, and customize any form with your practice information.  Please contact us at orders@theinsurancemaze.com if you have difficulty downloading any of these forms.

1. Sample Notice of Good Faith Estimate (to comply with the No Surprises Act, Jan 2022)
2. Sample Good Faith Estimate (to comply with No Surprises Act)
3. Sample Telehealth Informed Consent (to give to clients)
4. Telehealth Policies and Procedures (internal document insurance plans may want you to have)
5. Credit Card Authorization
6. New Client Registration Form
7. Treatment Agreement [aka Informed Consent] for Adults
8. Sample Treatment Agreement [aka Informed Consent] for Minors
9. Sample Treatment Agreement [aka Informed Consent] for Couples
10. Sample Superbill/Invoice with CPT Codes
11. HIPAA Notice of Privacy Practices (with no Psychotherapy Notes)
12. Intake Note Sample template (NEW as of 9/25!)
13. Griswold Progress Note Template (Recommended!)
    1. Griswold Note Template Pdf. version (template can’t be edited; updated 3.325)
    2. Griswold note template, Word version (can edit template)
    3. Griswold note template, Pages version (can edit template)
14. SOAP Progress Note Temple (updated 2.5.25)
15. DAP Progress note template (updated 2.5.25)
16. Discharge Summary Template (NEW 9/2025, updated 10/1/25!)
17. Sample Self-Pay Agreement; This form is for insurance clients wanting to pay out-of-pocket for services not covered by their insurance, (ex. extended sessions, educational workshops, or support groups), or for private-pay clients wanting to waive the use of their coverage (this must be their idea), or to attest they don’t have coverage
18. Checking Coverage: 13 Essential Questions
19. Out-of-Network Checking Coverage Form (to give to clients, or to check out-of-network coverage)
20. Coordination of Care with Other Treating Providers Form
21. Brief Mental Status Exam
22. Release of Information
23. Session and Payment Record (Tracks Sessions and Payments)
24. Fax Cover Page

Disclaimer:  While these forms are designed to meet common insurance plan expectations plus federal and state laws, each state and insurance plan has different requirements.  These sample forms are not meant to take the place of legal consultation regarding what should be in your medical records.  It is always recommended that the healthcare provider check with a client’s insurance plan to find out specific documentation expectations, and investigate state and federal laws that may apply to their situation.