Forms

FOR ADULT CLIENTS

Please READ these forms before your appointment:

Notice of Privacy PracticesDownload
Policy and Information for Adult ServicesDownload

Please PRINT, FILL OUT and BRING IN these completed forms to your appointment:

Client Information SummaryDownload
Acknowledgement of Receipt of Privacy PolicyDownload
Policy and Information for Adult ServicesDownload
Authorization for InsuranceDownload
Informed Consent for AdultsDownload
Authorization for Notification of BreachDownload

FOR PARENTS or GUARDIANS OF MINOR CLIENTS

Please READ these forms before your appointment:

Notice of Privacy PracticesDownload
Policy and Information for Services for MinorsDownload
Client Rights and ResponsibilitiesDownload

Please PRINT, FILL OUT and BRING IN these completed forms to your appointment:

Client Information SummaryDownload
Acknowledgement of Receipt of Privacy PolicyDownload
Informed Consent for MinorsDownload
Behavior Symptom ChecklistDownload
Authorization for InsuranceDownload
Authorization for Notification of BreachDownload
Personal History for Child/Adolescent ClientsDownload