Welcome to the pando bridge collective
We are glad you are here! Please fill out the Onboarding Paperwork and Releases of Information so we can start working on getting you the support you deserve!
(REQUIRED)
The above paperwork includes:
PROFESSIONAL SERVICES AGREEMENT
CLIENT RIGHTS & LEGAL DISCLOSURES FORM
CONSENT & AUTHORIZATION TO RECEIVE, DISCLOSE, AND EXCHANGE INFORMATION
FEE SCHEDULE
(REQUIRED FOR ADMINISTRATIVE SUPPORT SERVICES)
If you are hiring The Pando Bridge Collective to gather and submit paperwork, we will need a LOT of information, such as Provider names, insurance information, etc. The form linked above gathers as much information as we can so we don’t have to add to your task list by bothering you for the information later.
(If applicable)
This form is for if you need additional disclosures for exchange of information between third parties who do not have their own ROI forms
This form is to allow AETNA Insurance to disclose PHI to The Pando Bridge Collective. You will have to save and e-mail this form to info@pandobridgeca.com.
This form is to allow CALOPTIMA Insurance to disclose PHI to The Pando Bridge Collective. You will have to save and e-mail this form to info@pandobridgeca.com.
