Patient Forms

---

Please review and electronically sign the New Patient Intake Form:

New Patient Intake Form

---

Please review and electronically sign the Authorization for Release of Mental Health Information Form:

Authorization for Release of Mental Health Information Form

---

Please review and electronically sign the Authorization for Automatic Credit Card Payment Form:

Authorization for Automatic Credit Card Payment Form

---

Please review and electronically sign the Tele-MentalHealth consent form:

Tele-MentalHealth Consent Form

---

Please review and electronically sign the Informed Consent for In-Person Appointments:

Informed Consent For In-Person Appointments

---

---

Please download and complete the Intake/Child Developmental Questionnaire:

Intake/Child Developmental Questionnaire

---

---

---

---

Please review and electronically sign the Intern-Patient Intake Packet:

Intern- Patient Intake Packet

---

Please review and electronically sign the Intern-Release Form:

Intern- Release and Permission to Record Sessions

---

Please review and electronically sign the Intern-Patient Agreement Form:

Intern- Patient Services Agreement