Please print and fill out forms completely and bring to your initial appointment. Click on each form name below to View/Download/Print/Complete.
Adults
- Adult Demographics
- Adult Health and History Questionnaire
- Consent to Treatment
- Electronic Communication Informed Consent
- HIPAA Notice of Privacy Practices
(Please Read. Print if desired) - Authorization for Release of Your Clinical Information
(Print only if needed)
Adolescents
- Adolescent Demographics
- Adolescent Health and History Questionnaire – Guardian Portion
- Adolescent Health and History Questionnaire – Adolescent Portion
- Consent to Treatment
- Electronic Communication Informed Consent
- Minor’s Privacy Rights Related to Access, Inspection & Copying of PHI
(Please Read. Print if desired) - Authorization for Release of Your Clinical Information
(Print only if needed)
