Forms

All Clients

Please print, fill out and/or sign the following forms:

 Client Data

 Basic Information Acknowledgement

 Privacy Policy

 Electronic Communication Agreement

Insurance

If you will be using insurance, please print and fill out the following form:

 Release of Information for Insurance Billing

Additional Provider Release

If you have another provider you would like to give us permission to communicate with, please print and fill out the following form:

 Release of Information

For Your Records

The following forms are for you to keep for your records:

 Notice of Privacy Practices

 Basic Information and Treatment Agreement

 Electronic Communication Agreement