Patient Intake Forms

Please download and complete the following forms before your first appointment:

• Patient Registration (PDF)
• Health History (PDF)
• Non-Disclosure for Client (PDF)
• Notice of Privacy Practices (PDF)
• Release of Medical Records (PDF)
• Release of Information Consent (PDF)
• Financial Responsibility Form (PDF)

For Forensic Assessment only:

• Nonconfidentiality FCAS (PDF)
• Authorization for Mutual Release (PDF)