Forms

Forms

Adults: Read the HIPPA Document and the Adult Client Consent. ¬†Print and fill out the Adult Client Questionnaire 2016 and the Finance Agreement, and bring both to your first office visit. (Note that you do not have to print and bring the first two documents, but confirm that you have read them with a “check” on the Adult Client Questionnaire).

Parents of adolescents/adolescents: Read the HIPPA Document and the Adolescent.Parent Consent 2016. Print and fill out the Adolescent/ Parent Questionnaire 2016 and the Finance Agreement, and bring both to the first office visit.¬†(Note that you do not have to print and bring the first two documents, but please confirm that you have read them by putting a confirmation “check” on the Adolescent/ Parent Questionnaire 2013 handout).

HIPPA Document

FinanceAgreement

AdultClientConsent2016

Adult Client Information Questionnaire2016

Adolescent.ParentConsent2016

Adolescent.ParentQuestionairre2016