Forms to print prior to your first appointment:
Prior to your first visit, please print the following 5 forms and complete. Please either mail the forms in advance or bring these forms to your fist appointment. This will expedite the evaluation process and enable us to make full use of your session time. Additionally, please review the two forms in the following section ("Forms you do NOT need to print, but should review"). Your signature on the Consent to Treatment and Receipt of Privacy Practices forms indicates you have received and reviewed the Privacy Practices and Office Policy forms. Thank you.
First Visit Forms (click below to download):
REGISTRATION FORM
CONSENT TO TREATMENT
PATIENT MEDICAL HISTORY FORM
RECEIPT OF NOTICE OF PRIVACY PRACTICES
ELECTRONIC COMMUNICATION FORMS
First Visit Forms (click below to download):
REGISTRATION FORM
CONSENT TO TREATMENT
PATIENT MEDICAL HISTORY FORM
RECEIPT OF NOTICE OF PRIVACY PRACTICES
ELECTRONIC COMMUNICATION FORMS
Forms you do NOT need to print, but should review prior to your first appointment:
Please click the forms below to review the HIPAA regulations & Office Policies. You do not need to print these forms. Among the above-referenced forms is a form for you to print and sign acknowledging you have received and reviewed the HIPAA forms. Additionally, there is important information within the Office Policies, so please read this form carefully. Thank you.
PRIVACY PRACTICES
OFFICE POLICIES
PRIVACY PRACTICES
OFFICE POLICIES