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Forms

NOTICE OF PRIVACY PRACTICES (DOWNLOAD)

Teresa Romano, PLLC

Mallory Silberman, LCSW, PLLC

GOOD FAITH ESTIMATE

The No surprises act (H.R. 133) went into effect on January 1, 2022 where healthcare providers need to give clients who are not using insurance or do not have insurance a bill estimate for medical services. A Good Faith Estimate shows the cost of services that are expected for your medical and/or healthcare needs. To read more information about the Good Faith Estimate, download the form below

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