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Forms

Please print and complete the forms below. Please bring  forms, your drivers license, a copy of your insurance card and any form of payment you may have with you to your initial appointment. If you are unable to complete the forms prior to session, please arrive 30 minutes early, hard copies are made available in the lobby on the coffee bar.  If you are here under your Employer's EAP Program please bring a copy of your authorization code.   

Patient Information Sheet (docx)Download
Fee Agreement Consent to Treat (docx)Download
HIPPA (pdf)Download
Adult History (docx)Download
Good Faith Estimate (docx)Download
Notice of Privacy Practices Receipt (docx)Download
Treatment Plan (pdf)Download

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