Intake Forms

Our intake forms are provided here for you to fill out and bring to your first appointment. 
Click on the link to download the Word document to your computer. 

Adult Forms 
(download and click "Enable Editing "to print)
Click on Adult Forms to download

Includes the following forms:
- Fact Sheet
- Client History
- Consent to Use and Disclose Your Health         Information
- Privacy Practices
- Financial Policy
- Insurance Claim Form
- Release of Information

Minor Forms
Under 18 years old
(download and click "Enable Editing" to print)
​Click on Minor Forms to download

Includes the following forms:
- Fact Sheet
- Client History
-  Consent to Use and Disclose Your Health         Information
- Privacy Practices
- Financial Policy
- Insurance Claim Form
- Release of Information