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DOCUMENTS FOR CLIENTS

To expedite your visit, please download these forms for your review PRIOR to arriving to your scheduled visit. Read, sign, and bring these forms with you to your visit.  

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Patient Registration (English)

Notice of Privacy (English)

Reciept of Notice of Privacy (English)


Registro de Paciente (Espanol)

Notificacion Sobre Normas de Privacidad (Espanol)

Recibo Notificacion (Espanol)

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I accept the following insurance companies:  Blue Cross/Blue Shield, Cigna, Lovelace, MHN, Optum, Presbyterian Health Plan, United Healthcare, Value Options, and direct

Documents for Clients: Text

(505) 246-9972

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©2021 by Rosario Romero, LISW. Proudly created with Wix.com

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