Forms for new adult clients.
Please complete the following forms and bring them along with your insurance card to your intake appointment.
| Consent Form for Adult Clients |
| Adult Intake Form |
| Consent to Use and Disclose PHI |
| Patient Responsibility Form |
| Privacy Policies |
| Employee Assistance Program Form (for clients using EAP benefits) |
Forms for new child clients.
Please complete the following forms and bring them along with your insurance card to your intake appointment.
| Parent Consent Form for Child Clients |
| Assent Form for Adolescents (to be completed by adolescents aged 13-17) |
| Child History Form (to be completed by parent) |
| History Form (to be completed by adolescents aged 13-17) |
| Consent to Use/Disclose PHI |
| Patient Responsibility Form |
| Privacy Policies |
| Employee Assistance Program Form (for clients using EAP benefits) |