Please download, fill out, sign, and return the following forms to us before your therapy begins. Most of these forms, especially the longer ones, can be filled in on the computer if you prefer, and only need to be printed at the end for you to add your signature.
You can then either hand the completed, signed forms to your therapist, or you can scan then email or fax them to us. Both our email and fax services feature fully encrypted connections ensuring the security and safety of your personal information.
- Child Case History
- Authorization for Disclosure of Patient Information
- Audio, Photograph, and Video Consent
- 24 Hour Cancellation Policy
Please review our Notice of Privacy Practices (below), however, this does not need to be signed. Only the ‘Receipt of Notice of Privacy Practices’ should be signed to acknowledge that you received our Notice of Privacy Practices document.
If you are a private pay client, and you would like use a credit or debit card for payment, please also complete the following form: