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Start the journey now.
     this could be your turning point.

This could be the moment        

          when things get better

      

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Forms

NEW CLIENT PAPERWORK

First, review the following four documents (you may print these out for your own records):

Privacy Practices for Protection of Health Information (HIPAA)

Limits to Confidentiality

Rights and Responsibilities

Electronic Communication Policy

 

Next, print, complete and sign the following three forms and bring them to your first session:

Personal Information Form

Practice Information and Consent to Treat

Financial Responsibility and Signatures Page


If you would like us to coordinate care with another provider, for example, your psychiatrist, primary care physician, etc., please complete this form to authorize release of information.  This document is not required for your first session.
Release of Information Form




 

 


Note: To download Adobe Acrobat Reader for free, click here.

 

Helpful Forms

Click here to view and print forms for your appointment.

CLICK HERE