Forms available to download
Before your first appointment, please review our Office Policies and Informed Consent and complete the appropriate new patient information form. If you prefer, you can come 15 minutes early to complete these in my waiting room. There may be additional forms I send to you that are unique to your situation and reason for the appointment.
If you wish to save some time, follow the steps below:
Step 1:
From the list below, please select the personal information form best suited to your needs. Complete the form on-line, print it before exiting, and bring this with you to your first appointment.
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Child Intake Form (children up to age 17)
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Adult Intake Form (age 18 and older)
Step 2:
HIPAA regulations and good common sense require you to review information regarding our office policies, informed consent, and how your health care record is managed. Print and sign the final page of the Office Policies form. We need a copy of the signed last page for your file. Your signature just means you were given and read the form. It does not mean you are signing anything away or even that you agree with the material.
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Office Policies and Informed Consent (Again, bring both the completed personal information form and the signed Office Policies form to your first appointment.)
If other forms are needed, your clinician will contact you by email, sending any such forms to you as attachments.
