Forms
Client questionnaires
- Doctor Visit Update Form
- New Client Questionnaire
- Social Security, Unemployment and VA Benefits Information Sheet
Authorizations
- Authorization to Communicate
- Authorization to Release Information (General - non-HIPAA)
- HIPAA Authorization for Medical Records
- HIPAA Authorization for Psychiatric/Psychotherapy Records
Other client forms
Social Security forms
- Request for Social Security Earnings Information - Form SSA-7050-F4
- Your Social Security Earnings Statement – SAMPLE
- Appointment of Representative - Form 1696
- Authorization to Disclose Information to the Social Security Administration
SSA Form 827 - Claimant's Recent Medical Treatment
- Disability Report - Appeal - SSA Form 3441
- Disclosure of Confidential Information - SSA Form 3288
- Function Report - 3rd Party
- Function Report - Adult
- Request for Hearing Before Admin Law Judge - Form HA-501
- Request for Reconsideration - Form SSA-561
- Work History Report - SSA Form 3369
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