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Forms and Insurance

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Insurance & Registration Information:

Powerhouse Therapy is in-network with Blue Cross Blue Shield and Tricare. All other insurance companies are out of network. We will be happy to run your benefits to see what your coverage will be for our program. Cost of the program is also accepted with HSA.

Fill out and sign Registration Form, Emergency Medical Release, Medical Referral Form, and Consent to treat. Return Insurance form if you would like to bill insurance.

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Payment Information:

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Location:

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