Forms

Click the link below for the Child Intake Form (Under 18 years of age)

https://hipaa.jotform.com/220274742488057

Click the link below for the Adult Intake Form (Over 18 years of age)

https://hipaa.jotform.com/220274742488057

Click the link below for the Telehealth Consent Form

https://hipaa.jotform.com/220274742488057

Click the link below for Adult Questionnaire

https://hipaa.jotform.com/220274742488057

Click the link below for Child Questionnaire

https://hipaa.jotform.com/220274742488057

Click the link below for HIPAA Release Form

https://hipaa.jotform.com/220274742488057

Click the link below for Agreement to pay for mental health services out-of-pocket rather than use my insurance

https://hipaa.jotform.com/220274742488057

Click the link below for Agreement to pay for psychotherapy not covered by my insurance

https://hipaa.jotform.com/220274742488057