Client Forms

If you are a new client, please be sure to fill out and bring in the below required forms to your first appointment. I will let you know if any of the supplemental forms are needed.

Fill out and complete one of the below for each individual participating in therapy.

Required Forms

Client Intake Profile
Informed Consent & Practice Policies
Notice of Privacy Practices Acknowledgement
Consent to Treat a Minor (if any client is under the age of 18)
Notice of Privacy Practices (please keep for your records)

Supplemental Forms

Caregiver Affidavit
Symptom Inventory for Adults
Symptom Inventory for Parents (of children ages 6-17)
Symptom Inventory/ Self Report for Children (ages 11-17)