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Forms

The forms below are to be completed after you have scheduled an initial appointment. Please go to our "Scheduling and Billing" page to learn how to schedule an appointment.  


Please complete all five steps below (1. Informed Consent to Treatment, 2. Billing Consent, 3. Intake Data Sheets, 4. Telepsychology Consent, and 5. Notice of Privacy Practices).  If you click on the links to complete forms online, you will be redirected automatically to a secure site for each form. If you print and complete the forms by hand, please bring them with you to your first appointment. Thank you! (To print the forms you must have Adobe Acrobat Reader Installed.  You may download this for free using the button at the bottom of the page.)

 
Therapist

1.  Informed Consent to Treatment  

Click the link to fill out this form online, or click the button to print:

Smiling Nurse

2.  Billing Consent 

Click the link to fill out this form online, or click the button to print:

Legal Representation

3.  Intake Data Sheets

Click the link to fill out this form online, or click the button to print:

Computer Software Guidance
Shake on It

5. Notice of Privacy Practices (NPP)

Click below to read the NPP (which you may print for yourself if you wish):