FORMS

If you have scheduled an appointment with one of our counselors, you may print out the registration forms at home, fill them out and bring them with you to your initial appointment.

Please complete the Registration, Insurance, Treatment Agreement and Receipt and Acknowledgement of Notice of Privacy Practice forms.

To access a printer friendly version of the forms click on the following:

Patient Registration Form

Treatment Agreement

Insurance Authorization Form

Notice of Privacy Practices

Receipt and Acknowledgement of Notice of Privacy Practices

YOU ARE WELCOME TO CONTACT US FOR MORE INFORMATION REGARDING OUR SERVICES.

HOWEVER TO AVOID NO-SHOW FEES, PLEASE PHONE OUR OFFICE TO CANCEL OR CHANGE AN APPOINTMENT. CANCELLATIONS AND CHANGES COMMUNICATED BY E-MAIL CANNOT BE ACKNOWLEDGED OR ACCEPTED.