Print out, fill out, and bring with you

Intake form

Agreements/Policies

SunSpace Notice of Privacy Practices

Additional Forms

The following are forms to submit for reimbursement for out of network care.  These forms are provided as a courtesy only and are not guaranteed to be accurate. Please verify with your insurance provider which claims are needed for reimbursement purposes:

Cigna
Premera
Regence
United HealthCare
Aetna