NEW CLIENT REGISTRATION
Please bring your completed New Client Registration Packet and your Therapist’s Disclosure Statement to your initial appointment. In addition, please review our Notice of Privacy Policies and you may click on this link to print a copy for your records. If you do not have time to complete the registration packet ahead of time, please plan to arrive 20 minutes prior to your appointment to complete in our lobby.
YOUTH REGISTRATION (Ages 2-12):
ADULT REGISTRATION (Ages 13+):
|Couples, please complete & sign separate Adult Registration packets.|
ESTABLISHED CLIENT FORMS:
- Credit Card Authorization Form: Simplify making co-payments using our Credit Card Authorization Form. This information is kept on file in our secure electronic HIPAA compliant medical records program.
- Telehealth Consent
- Release of Information (ROI): Learn more about Requesting Medical Records.
THERAPIST’S DISCLOSURE STATEMENTS: