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Individual Forms
Don't need the whole packet?
Just click, print, and bring the forms you need with you to your visit!
Medical forms cannot be emailed.
Covid-19 Policy
This acknowledgement form is required for all sessions booked after July 10, 2020
Service Agreement
This acknowledgement is required for your first session, and will not need to be filled for subsequent sessions.
Insurance Benefits and Eligibility
This form is required for all sessions.
Financial Policy
This acknowledgement form is required for your first session, and will not need to be filled for subsequent sessions.
HIPAA Privacy Notice
This acknowledgement form is provided to you at your first session, for your review.
Cancellation Policy
This acknowledgement form is required for your first session, and will need to be reviewed and signed again after each missed session.
Consent for Disclosure & Release
This acknowledgement form is required for your first session, to be revised and re-submitted as needed.
Adult Client Registration
This acknowledgement form is required for your first session, and will not need to be filled for subsequent sessions.
Recording Authorization
This form is required for your first session, and will not need to be filled for subsequent sessions.
Child Client Registration
This acknowledgement form is required for your first session, and will not need to be filled for subsequent sessions.
Acknowledgement of HIPAA Privacy Notice
This acknowledgement form is required for your first session, and will not need to be filled for subsequent sessions.
Social Media and Communications Policy
This acknowledgement form is required for your first session, and will not need to be filled for subsequent sessions.
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