Forms

– FORMS –

• Adult Client Intake Form

• For Minors, the following form must be completed and signed by both parents (or legal guardians) prior to the first session

  • Intake Form for Minors

• Release of Information Form –if you are on medication, please fill this out so I can communicate with your doctor

• Notice of Privacy Practices (HIPAA notice)

• Client BCBS/Blue Choice PPO Storm Billing Initial Information Form – for new patients using insurance