Archived Forms

Administrative

Compliance

• Code of Conduct
• CMS Recovery Letter
• HIPAA Restricted Visit Policy
• ICD-9 & ICD-10 Code Mapper
• ICD-10 Will Change Everything
• Malignant ICD 9 Codes

Human Resources

• Confidential Employee Data Form
• Confidential Employee Data Form Option 2
• Employee Exit Checklist
• Employee Exit Form
• How Does Management Rate with your Employees
• I-9 Form
• Request for Leave of Absence

Insurance

• Deductible Reassignment Template
• Notice of Non-Covered Service

Patients

• Patient Portal Set-Up Form
• Patient Portal Information

Emergency Planning

• Business Emergency Response Plan
• Emergency Preparedness Planning: 10 Practical Tips

Other

• Abbreviations 
• Cosmetic Intake Form
• Physician Departure Letter

Employment

Evaluations

• 90 Day Clinical Evaluation
• Annual Evaluation Form
• Employee Self Evaluation

Job Descriptions

• Clinical Medical Assistant Job Description
• Follow Up Biller Job Description
• Front Desk Job Description
• Office Manager Job Description
• Medical Billing Department Coordinator Job Description
• Medical Assistant Job Description
• Medical Receptionist Job Description

Other

• Employee Action Plan
• Employment Application
• Incident Report
• PIP/Employee Discipline Report
• Personal Physician Information
• Physician Credentialing Information 
• Total Employee Compensation Statement

Financial Policies

• Financial Agreement for Cosmetic Procedures
• Financial Hardship Agreement
• Financial Policy A
• Financial Policy B
• Financial Policy C
• Financial Policy D
• Internal Refund Request
• Letter to Patient NSF Check
• Medical Records Invoice A & B
• Patient Responsibility Letter
• Pediatric Financial Policy
• Surgical Cost Analysis

Informed Consent

• Botox
• Confidentiality and Security Agreement
• Humira
• Minor Surgical Procedure
• Photodynamic Patient Consent
• Photodynamic FAQ
• Photodynamic Post Procedure Instructions

Logs

• Acne Flow Sheet
• Biopsy
• KOH
• Photodynamic Treatment Record
• Pre-Treatment Photodynamic Log