Eligibility Verification CLIENT INTAKE Client Resources Billing Submission Program Evaluation Other Documents


2. Client Intake


After completing membership verification, you should send the PVP Informed Consent to Treat Form to the member after setting up an appointment. It is a signable Adobe Acrobat file, although members may choose to print it and fill it out manually. The consent to treat is designed to create discussion between you and the member during your first session.  

  • PVP Informed Consent Form - please send this to the client upon making an appointment and have them sign it during your first session. You will also need them to sign it after each renewed 12-month benefit period.
    • Demographics Tracking Card - this form is now combined with the consent to treat form. Rely on the member to fill out the form and ask for information they'll provide to fill the blanks. Print or save for tracking in your client file to assist you with billing demographics. You will also need to fill one out after each renewed 12-month benefit period on the first billing appointment of that period.
    • Program Evaluation Form - Please provide it to the client during your first session and ask them to fill it out upon completion of services or after they have used up their benefit year sessions. This is also combined with the consent to treat form but a separate file is included here.

<---Previous Step 1. Eligibility Verification | Next Step 3. PVP Provider and Client Resources --->