NEW PATIENT PACKET
Once our office has scheduled your initial evaluation appointment, we'll ask you to submit the New Patient Forms.
You can complete the paperwork one of two ways:
1. Click on the icon to the left to print out the paperwork. You'll need to scan and email the documents to the office. (This packet includes an Acknowledgment of Receipt of our Privacy Practices. You're welcome to read about our privacy practices here.)
- OR -
2. Click on each of the buttons below to complete the online version of the forms. These forms are stored securely on our HIPAA compliant cloud drive and your responses will update automatically. This is the more expedient, secure way to forward your information to our office.
*You can click on both buttons now and a new tab for each form will open in your browser window.
RELEASE OF RECORDS AUTHORIZATION
Our Authorization to Release Confidential Information form is used for allowing our office to retrieve protected records from another medical or mental health provider and/or release your protected records to another person (another provider, family member, attorney, or disability service for example.)
NOTE: It's important to fill this form out in its entirety and include an original signature so we're able to obtain or release your protected personal health information.
Because we adhere to more stringent guidelines for protecting our client's personal health records, all requests must include the client's (or parent/guardian) original signature.