To download patient forms, click on the icon next to the form description. Please download, fill out, and bring these forms with you to your first appointment. Adults should complete the ‘Patient Consent – Adult’ form. Parents of minors should complete the ‘Patient Consent – Minor’ form.

The Information Release form is optional and should only be filled out if there is another party with whom you want the psychologist to share information with.

Patient Information

PDF file, approx. 176KB

Patient Consent – Adult

PDF file, approx. 180KB

Patient Consent – Minor

PDF file, approx. 170KB

HIPAA Privacy

PDF file, approx. 200KB

Information Release

PDF file, approx. 170KB

Payment Authorization

PDF file, approx. 160KB