Forms

INTAKE FORMS

 

In order to best serve you, new Clients will need to complete some forms prior to our first session. Download and save the forms below for your records. For your convenience, after you've read and if you agree, simply click the links to sign and submit at least 18 hours prior to your first session. 

RECORDS REQUESTS 

For record requests, a preparation fee of $22.88 is required if the records are being sent to another provider.The federal HIPAA regulations do not allow a fee for records provided directly to the patient.

 

A preparation fee of $70 is required for treatment summaries and special letters.

 

Click the button below to submit your request.

*Please allow 30 days for turnaround.