You must fill out and sign the two documents below before your first visit
The third file is for video or phone sessions
You may type in the information, then print.
Choosing Download will open a new window or tab
The third file is for video or phone sessions
You may type in the information, then print.
Choosing Download will open a new window or tab
Health Insurance Claim Form | |
File Size: | 140 kb |
File Type: |
Intake Form & Privacy Policy | |
File Size: | 178 kb |
File Type: |
Informed Consent for Telepsychology | |
File Size: | 327 kb |
File Type: |
If you are on any medications prescribed by medical doctors or under psychiatric care, please fill out the health care coordination form below so as to coordinate treatment.
health_care_coordination_form_fillable_with_fax_mailing.pdf | |
File Size: | 70 kb |
File Type: |