IMPORTANT: To save you time, please click the button above to be taken to our electronic forms page.
If you are not able to complete the electronic forms, or prefer to print the forms and fill them out by hand, please click here.
PAPER FORMS:
Please read and fill out these forms prior to your first session.
FORMS TO READ
- Client Policy
- Communication Policy
- HIPAA Information
ADULT CLIENTS - FORMS TO FILL OUT
- Client Information Form
- Physician Release Form
- Patient Health Questionnaire
- Generalized Anxiety Disorder Survey
- Client Signature Form
- Telehealth Informed Consent Form
MINOR CLIENTS - FORMS TO FILL OUT
- Client Information Form
- Consent to treat Minor
- Physician Release Form
- Safe Harbor Agreement
- Client Signature Form
- Telehealth Informed Minor Consent Form
Before your first session, please complete our Electronic Intake Forms (click the link or the button to the left).
If you prefer to use paper forms, please read the forms on the left under FORMS TO READ. Once you done reading the above information, please print and fill out the additional forms on the left for either Adult clients (under the section ADULTS CLIENTS - FORMS TO FILL OUT) or Minor clients (under the section MINOR CLIENTS - FORMS TO FILL OUT). Please bring these completed forms to your first session.
Fees: The fee is $150 per hour and psychological testing is billed on an hourly basis plus the cost of the test. An initial assessment session is required, and is billed at $160. We are currently a provider for all insurance companies.
If you need to cancel an appointment, we ask that you provide 24 hours notice by calling Monday through Friday. Please respect that we reserve this time for you.