Forms

New Patient Forms:  Please print out the following forms, complete them, and bring them with you to your first session.

Child/Teen Forms (Please complete both):

New Patient Information – Child

Informed Consent and Office Policies

Adult Forms (Please complete both):

New Patient Information – Adult

Informed Consent and Office Policies

Credit Card Authorization: If you plan to pay by credit card, you may print and complete this form

Credit Card Authorization Form

Authorization to Release Information (ONLY COMPLETE IF DIRECTED – Please sign, date, enter time, have witness sign):

– Authorization