Forms

Download the Form

Click on the requested form below to download the PDF to your device.

Complete the Form

Clients may complete the requested form in EITHER of the following ways.

Fill in the form on a device.

This can be done by using a document completion software such as Adobe Acrobat Fill & Sign.

- OR-

Print the form onto paper.

You will fill it out by hand.

Submit

the Form

Return your completed form to Dee using ANY of the following methods.

UPLOAD THE FORM

To upload the form securely to Dee, scroll down on this page to use the "Upload Documents" submission feature.

Note: Uploads should be formatted as a PDF, JPEG or PNG file.

EMAIL THE FORM

Attach the form (as either a scanned document or as photos) in an email to me at:

deewashburn@tsecuremail.com

TAKE PHOTOS OF THE FORM

Take a photo of the completed form and send the photo(s) to my cell phone at:

(540)-591-9911

Note: This is not a HIPAA compliant method.

FAX THE FORM

Fax the completed form to me at:

(540)-591-9914

MAIL THE FORM

Mail the completed form to me.

Address available upon request

Upload Documents