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Client Forms and Information

STANDARD NOTICE: Right to Receive a Good Faith Estimate of Expected Charges Under the No Surprises Act

 

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

Adults

Adult Intake Forms

Adult Consent to Receive Services

Telehealth Informed Consent

Credit Card Authorization

Authorization to Release Protected Health Information: Required for referrals and/or release of psychological assessment/evaluation information to another provider (physician, psychiatrist, etc.).

Children and Adolescents

Child and Adolescent Intake Forms

Child and Adolescent Consent to Receive Services

Telehealth Informed Consent

Credit Card Authorization

Authorization to Release Protected Health Information: Required for referrals and/or release of psychological assessment/evaluation information to another provider (physician, psychiatrist, etc.).

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