Forms

Please complete the appropriate forms before your first session.  If you will be using insurance, please contact your provider in advance to obtain pre-authorization, if required.  If you need assistance, please don’t hesitate to contact us.

General

• Patient Consent for Use of Email Communication & Statements

Adults

• Financial Agreement and Insurance Information Form
• Adult History Form
• Confidential Communications & Alternative Contact Info
• Consent to Disclose Information
• Notice of Privacy Practices
• Patient Health Questionnaire
• Adverse Childhood Experience (ACE) Questionnaire

Children

• Financial Agreement and Insurance Information Form
• Child and Adolescent History Form
• Confidential Communications & Alternative Contact Info
• Consent to Disclose Information
• Notice of Privacy Practices