| Adult Paperwork: |
ADOBE
PDF |
| Psychological
Services Agreement -
Adult |
|
|
| Background
Information - Adult |
|
|
| Adult Consent
to Treat |
|
|
| Notice of
Privacy Practices |
|
|
| Child Paperwork: |
|
| Background Information - Child |
|
|
| Consent
to Treat Ages 14-17 with Parent Consent |
|
|
| Consent
to Treat Ages 14-17 without Parent Consent |
|
|
| Consent
to Treat All Ages Under 18 |
|
|
| Psychological Services Agreement - Child |
|
|
| Notice of Privacy Practices |
|
|
| Insurance Paperwork: |
|
| Insurance
Verification Script |
|
|
| Insurance
Information Form |
|
|
| Authorization to Release Information: |
|
| Authorization to Release Information |
|
|
| Credit Card Authorization Forms: |
|
| Credit Card
Authorization Form - Telephone or e-Therapy |
|
|
| Credit Card
Authorization Form - 1st Session, Bills, co-pay |
|
|
| |
| |
