Forms & What to Bring
Please download, print, and complete the following forms prior to our first appointment.
1) Consent to Treatment Form
2) Email Authorization Form
3) Financial Responsibility Form
4) Notice of Privacy Act
5) Privacy Act
6) Release of Information Form – This form allows clinicians to contact third parties such as, physicians, teachers, etc.
7) If applicable, please bring a copy of patient’s insurance card.
8) Please bring copies of previous records (i.e., copies of previous assessments, relevant medical records, grade reports etc).