Prior to your first appointment, please print and complete all the documents below that apply to you, the patient. (Note: Adults have two forms to print and complete, and adolescents and their parents have three forms to print and complete.)
If you bring the completed paperwork to your first appointment, you need arrive only 15 minutes before your appointment time.
If you are unable to bring the completed documents you must arrive 40 minutes before your appointment time. There will be a copy of all the documents and the Notice of Privacy Practices in the waiting room.
|Complete Two Adult Forms for Patients 18 Years and Older:|
|Adult Treatment Agreement|
|Adult Clinical Intake Questionnaire|
|Complete the Following Three Forms for Patients 17 years and younger:|
|Minor Treatment Agreement to be completed by Parent/Guardian & Patient|
|Minor Clinical Intake Questionnaire to be completed by Patient|
|Minor Clinical Intake Questionnaire to be completed by Parent/Guardian|
PLEASE DO NOT STAPLE OR HOLE PUNCH DOCUMENTS
Prior to your first appointment, please read the Notice of Privacy Practices as this outlines your rights under the Health Insurance Portability and Accountability Act. You may print this document for your files.
|Notice of Privacy Practices|