Please complete and email the intake paperwork prior to your first appointment to firstname.lastname@example.org. You may also print and bring the completed forms if you are unable to email them.
If you are unable to complete the forms at home, please arrive 20 minutes prior to your appointment to fill them out in the office. Thank you!
Release of Information- Emergency Contact:
Telehealth Consent Form:
Informed Consent Agreement:
Assignment of Benefits:
Appointment Reminder Preference Form:
Family/Medical/Psych History (Adult):