Insurance & Fees
No insurance will be billed and no insurance payments will be collected by this office. Our fees will be collected on a monthly, quarterly, biannual or annual basis depending on which payment plan suits you best.
New Patient Forms
Please print and complete the forms below and bring them to our office. Or once you have your patient portal access you may fill the new patient forms online thru the portal. Completing the forms online is preferred.
Complete Packet
- New Patient Forms Packet (15 pages)
Individual Forms
If you need an individual form from the packet above, please select that form from the list below.
- Membership Contract
- New Patient History
- Patient Behavior Contract
- Insurance Statement
- Medical Records Release - allows us to view records from other hospitalizations/ providers
- HIPAA Notice of Privacy Practices
- HIPAA Authorization Form
Patient Portal
Our secure patient portal is available for new patient signup 24 hours each day. Once we receive your request, we will contact you to set up your first appointment.
Bill Payment
Manage your bill payment through the patient app. You will be sent an invitation to add the app after your first appointment.
Schedule a Visit
You may call our office during office hours at 702-305-3293 or info@hendersonim.com or schedule through the patient app. The patient app can be made available after your first visit. Please note that self booked appointments are subject to verification by office staff before they are considered confirmed.