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 |
| Intake Form & Privacy Policy |
| Informed Consent for Telepsychology |
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 |