In order to make your visit begin more smoothly, please download the forms below, and fill them out prior to your first visit to Active Rehab. This information is required, and will help us better serve you. Please arrive in our offices 15 minutes before your appointment to fill them out if you don't have time to do so before you arrive.
Below is a list of forms for your convenience:
  Health History
  HIPPA Notice of Privacy Practices
  Acknowledgement of Receipt of HIPPA Notice of Privacy Practices
  Registration Form
  Clinic Financial Policies
  Insurance Form

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             Privacy Policy Vallejo   707-648-3144 El Sobrante   510-243-1871