Forms

For your convenience, the listed forms are available for you to complete, print, and bring with you to your first appointment.

All forms are in Adobe Acrobat format. This format allows users to print these files to any printer, using the Adobe Acrobat Reader program. Adobe Acrobat Reader is available at no cost for download from the "Get Acrobat Reader" button below.

General Information & Office Policies Agreement

Client Services Agreement

General Information & Office Policies Agreement

Telemedicine Informed Consent Form

Authorization to Exchange and Release Confidential Information Form

Authorization to Exchange and Release Confidential Information Form

Health Insurance Portability and Accountability Act (HIPAA) Form

Health Insurance Portability and Accountability Act (HIPAA)

Adult Information Sheet

Adult Information Sheet

Minor Child Information Sheet

Minor Child Information Sheet

Credit Card Authorization

Credit Card Authorization

“No Secrets” Policy for Family Therapy and Couple Therapy

“No Secrets” Policy for Family Therapy and Couple Therapy