Registration

Registering With TYGR

To begin therapy we will need:

1. Doctors Prescription for therapy services (OT and/or PT) with ICD-9 code and frequency of visits
2. Completed TYGR Client Registration (Click here for form) and Liability and Risk Indemnity Agreement (Click here for form) , along with a signed copy of TYGR Contract Conditions (Click here for form).  Please complete and fax to: 773-572-4886 so we can call in for benefits verification.  Failure to complete prior to services will require you to pay in full at time of appointment.
3. Insurance Information: Copy the Front & Back of your primary and secondary insurance. 
4. A copy of TYGR HIPPA Statement (click here for form)  for your personal records. 

Fees: TYGR accepts private pay and insurance.  TYGR now has Network Provider status with Blue Cross Blue Shield.  Please complete and fax Client Registration form to: 773-572-4886 prior to scheduled service date so we can call in for benefits verification. All co-insurance, co-payments and payments to deductible are due at the time of service.