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Counseling Services

Individual
Marital & Couples 
Relationship Issues
Grief and Loss
Anxiety & Fears
Depression
Personal Growth
Parenting Support
Stress Management

African American Mother with Daughter
Family Having Fun

New Patient Forms

PLEASE DOWNLOAD, COMPLETE/SIGN ALL FORMS LISTED BELOW (WITH THE EXCEPTION OF THE EMOTIONAL SUPPORT ANIMAL/ESA EVALUATION PACKET UNLESS YOU ARE AN ESA PATIENT) AND BRING THEM WITH YOU TO YOUR INITIAL APPOINTMENT.  THIS MUST BE DONE PRIOR TO BEING SEEN UNLESS EXTENUATING CIRCUMSTANCES HAVE BEEN DISCUSSED IN ADVANCE.  

THANK YOU!

Welcome Informed Consent Form

Missed/Late Cancel Policy Form

ESA Psychological Evaluation Form

HIPAA Confidentiality Form

Notice of Privacy Practices

Adult Patient History Form

Patient Insurance Form

Authorization To Disclose Information

Innovative Billing Solutions


Note: To download Adobe Acrobat Reader for free, click here.

 

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Helpful Forms

Click here to view and print forms for your appointment.

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