Forms

 INDIVIDUAL FORMS

If you are 18 or older, please print, complete and bring the following forms to your first appointment.

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Authorization to Release Information

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Adult Informed Consent With Telemental Health and Policies

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HIPAA Notice of Privacy Practices

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Client Information Form (Adult)

 

ADOLESCENT FORMS

If the person with a session is under the age of 18, please print, complete and bring the following forms to your first appointment.

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Adolescent Parental Informed Consent and Policies

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HIPAA Notice of Privacy Practices

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Authorization to Release Information

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Client Information Form (Child)

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Adolescent Informed Consent & Administrative Policies

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Parental Assessment for a Minor

 

NURSING AND MEDICATION INTAKE FORMS

Notice of Privacy Practices

Information and Consent for Treatment

Authorization ROI

Mental Health Intake Form

HIPAA Compliance Patient Consent Form