Providing mental health services for adults, adolescents, and children in the Chattanooga area since 1999

Client Registration and Information

To expedite the check-in process at your first appointment, please print and complete the appropriate forms to bring with you.

Adult Intake Packet

Child and Adolescent Intake Packet

Please print and complete the following form if you would like to coordinate care with another provider (primary care physician, psychiatrist, etc.). If you would like psychological assessment/evaluation information sent to your doctor, you must complete this form and return it with your intake packet.

Authorization to Release Protected Health Information

The following forms are available for your review. You do not need to print them to bring in to your first appointment. However, in the intake packet, you will be asked to sign that you have reviewed this information and agree to the terms outlined therein.

Notice of Privacy Practices

Provider and Client Service Agreement

Telehealth Forms

These forms are required for all clients utilizing telehealth services.

Telehealth Informed Consent

Telehealth Credit Card Authorization