Release of Information Forms
Screening Process Forms
Screening forms will be sent to you by our Office Manager.
Evaluation Appointment Forms
Below are the forms that will be completed when our Office Manager contacts you to schedule an Evaluation Appointment at the clinic. We currently deliver these forms electronically for your electronic signature, using HIPAA-compliant methods. Therefore these are listed below for your review only, if you would like to familiarize yourself with our Evaluation procedures.
If you have people you want to give us permission to communicate with (your PCP, psychiatrist, another therapist, your employer/school, etc) please complete the ROI forms at the top of the page as well, and bring those to your appointment.
If you have people you want to give us permission to communicate with (your PCP, psychiatrist, another therapist, your employer/school, etc) please complete the ROI forms at the top of the page as well, and bring those to your appointment.
Please review the Notice of Privacy Practices below before attending your first evaluation appointment. You don't need to bring this document to your appointment.
Treatment Forms
Please complete the following form when you begin Treatment at the Clinic. Please bring this form to your first treatment session at the clinic, and give it to your treating clinician. If you have people you want to give us permission to communicate with (your PCP, psychiatrist, another therapist, your employer/school, etc) please complete the ROI form at the top of the page as well, and bring those to your appointment also.
