- Forms 1-6 are REQUIRED FOR ALL NEW CLIENTS.
- Form 7 is REQUIRED for all CLIENTS YOUNGER THAN 18 YEARS. Form 8 is REQUIRED for all clients 18 YEARS OR OLDER.
- Forms 9 and 10 are for use as needed.
1) HIIPA Please READ prior to first appointment
2) HIIPA Acknowledgement Please COMPLETE AND BRING to first appointment
3) Policies and Procedures Please READ prior to first appointment
4) Agreement for Services and Consent for Emergency Care Please COMPLETE AND BRING to first appointment
5) Email and Social Media Policy Please COMPLETE AND BRING to first appointment
6) Teletherapy Consent Form For clients who are arranging to visit with their therapist ONLINE.
7) Parent Questionnaire For MINOR (younger than 18 years) clients only - please COMPLETE AND BRING to first appointment.
8) Adult Questionnaire ADULT clients only - Please COMPLETE AND BRING to first appointment.
9) Credit Card on File Authorization For clients who wish to pay by Visa, Mastercard, Discover, Amex, or HSA card.
10) Authorization for Disclosure For use as needed
2) HIIPA Acknowledgement Please COMPLETE AND BRING to first appointment
3) Policies and Procedures Please READ prior to first appointment
4) Agreement for Services and Consent for Emergency Care Please COMPLETE AND BRING to first appointment
5) Email and Social Media Policy Please COMPLETE AND BRING to first appointment
6) Teletherapy Consent Form For clients who are arranging to visit with their therapist ONLINE.
7) Parent Questionnaire For MINOR (younger than 18 years) clients only - please COMPLETE AND BRING to first appointment.
8) Adult Questionnaire ADULT clients only - Please COMPLETE AND BRING to first appointment.
9) Credit Card on File Authorization For clients who wish to pay by Visa, Mastercard, Discover, Amex, or HSA card.
10) Authorization for Disclosure For use as needed