Client Forms

If you are new, please be sure to fill out the following forms, and bring them to your first session. This will help ease you in and allow as much time as possible to focus on you.

Good Faith Estimate

Consent to Release Medical Records

Credit Debit Card Payment Consent Form

Mental Health Intake Form

No Harm Contract

No Show Late Cancellation and Co-Payment Policy

Notice of Privacy Practices

Patient Information Update

Patient Registration Form

SA Intake Form

Treatment Consent for Minors

If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

Authorization for Release of Information

 

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