Testing & Therapy Services Forms

Thank you for choosing ACAPS as your health care provider. To best serve you, please choose the category of forms which best fit the reason you are seeking our services. Print, complete, and return the forms to mail: 600A Centrepark Dr., Asheville, NC, 28801 by Fax: (828) 575-9761

Child/Adolescent Testing Services

(Ages 5 – 17 years old)

Welcome to ACAPS

Introduction Packet

Patient Registration Form

Rights & Consent to Treat Form

Methods of Payment

Child Questionnaire

Credit Card Information must be provided by all patients except Medicaid patients.

Debit/Credit Card Authorization Form

Adult Testing Services

(18 years and above)

Welcome to ACAPS

Introduction Packet

Patient Registration Form

Rights & Consent to Treat Form

Methods of Payment

Adult Questionnaire

Credit Card Information must be provided by all patients except Medicaid patients.

Debit/Credit Card Authorization Form

Therapy Services

Welcome to ACAPS

Patient Registration Form

Rights & Consent to Treat Form

Methods of Payment

Credit Card Information must be provided by all patients except Medicaid patients.

Debit/Credit Card Authorization Form