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Helpful Forms and Information

Your First Appointment

When you arrive at the office waiting room, there will be a button to push with your clinician's name. Please press the button to let us know you have arrived.


Your first appointment will be an intake session lasting 90 minutes unless otherwise specified. Please download the forms below and bring them to your first session. If you are an adult over the age of 18, please complete the Adult Intake forms and bring them with you.

If the appointment is for your child, please complete the Child Intake forms and bring them with you. Please do not bring your child to the intake session. It is important for parents to be able to talk privately about their concerns without the child present. If you are divorcing or are divorced, you must bring the section of the divorce decree outling who can authorized health care. You must also complete the intake form addressing custody dispute matters. If at all possible, both parents need to be at the intake session. 

If you do not have a computer available to download the forms, please let your clinician know so we will have the forms availible at your appointment.Please plan to arrive 20 minutes early to complete the forms.

Payments

Mastercard, Visa, Discover, check or cash are accepted for payment. All clinicians are out of network providers for insurance companies and will give you a statement to send to your insurance company if desired. Please note that you should check your out of network benefits prior to making an appointment. We also accept Health Savings Cards and Flexible Spending Accounts. Please note that some insurance providers may not reimburse for interns. Please check with your clinician to discuss their fees.

Child and Adolescent Intake Forms

In order to prepare for your first appointment, please download the appropriate forms and bring them to your first appointment.  If the appointment is for your child, please complete:


The first appointment for children is for parents only in order to get a confidential and accurate history of the problem.  Please do not bring your child or their siblings with you.The appointment will be for 90 minutes unless notified otherwise.

Adult Intake Forms

Please download and  complete the following forms to bring with you to your first appointment.

1. Adult Intake Questionnaire
2. Consent for Treatment Form 
3. Authorization to Disclose Information Form to coordinate care with your physician.
4. Notice of Privacy Practices Please review this information and keep a copy for your records. 


The intake appointment will be scheduled for 90 minutes unless otherwise notified.

 

Note: To download Adobe Acrobat Reader for free, click here.

 

Please also note our social media policy: 

Our therapists cannot accept friend or contact requests from current or former clients on any social or professional networking site. We believe that adding clients as friends or contacts on these sites can compromise your confidentiality and may blur the boundries of our therapeutic relationship. We do have a professional practice page you are welcome to view or subscribe for updates where we share relevant articles and publically availible information regarding our practice. 

 

 

Helpful Forms

Click here to view and print forms for your appointment.

CLICK HERE