Forms

DOWNLOAD AND PRINT THE APPLICABLE FORMS BELOW TO SAVE TIME DURING YOUR FIRST APPOINTMENT.

If you are unable to fill out the necessary forms or have any questions, please arrive at least 10 minutes early and we can assist you. Once you have the forms, please contact us to make an appointment and get started on your journey to a more effective life. If you do not see a situation-specific form, please contact us and we will be happy to help.

General Intake Form

Consent for Treatment

HIPAA

HIPAA Disclosure Form

Level 1 Cross-Cutting Symptom Measure – Adult

Level 1 Cross-Cutting Symptom Measure – Child