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Forms

New Patient Forms

Please click on the links to the forms below, print, and fill out before your first appointment.

  

 



Intake and Insurance Form
Fill out for all new patients







Child History Form

Fill out for ONLY new child patients






Adult History Form

Fill out ONLY for new adult patients     


                            




Minor Consent for Parents

For minors age 12-17 - print out but do not sign





Credit Card Authorization Form

Required for all new patients


 

 Additional Patient Forms

  





Consent for Information

Release needs to be signed for any collaborative communication between

                                    the therapist and other professionals

 





Privacy Practices Form

Please read my Privacy Practices Notice and print out and sign page 5, Signature Page

                                    and bring in to your first appointment