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Initial Appointment Forms

If you are a new client, please complete the following forms and bring them to your first therapy session.
Insurance Verification Form.pdf

Assignment of Benefits Form.pdf

Child- Adolescent Form-Intake.pdf

Adult Intake Form.pdf

Consent To Treatment.pdf

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We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

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By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.

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Helpful Forms

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