New clients are required to review and sign certain forms at the time of their initial appointment.
You may obtain this information and the admission forms prior to your initial appointment by downloading and printing the forms below. You must bring the forms you are required to complete with you to your initial appointment. If you do not wish to review and download these forms now, we will mail them to you or you may arrive 30 minutes early to your initial appointment and complete them at that time.
(Please review the instructions below and click on the forms to download and print.)
We require all new clients to complete and sign the following Registration and Consent forms as part of our admission process. The forms in the Client Registration Packet must be brought to your initial appointment. Please also print, sign and bring the Consent for Telehealth Services form with you should you want telehealth services at some point during your treatment.
In order to give your psychiatrist or psychotherapist some background information about your problems, all new clients are asked to complete a history form. Please bring the following forms with you to your initial appointment.
Adult clients are asked to complete the Family History Form.
Parents/guardians of children and adolescents who are seeking treatment are asked to complete the Child-Adolescent History Form.
New clients are also required to review the following forms prior to their initial appointment. (These forms are for your review, you do NOT need to bring them to your initial appointment.)
Financial Policy & Fee Schedule
Notice of Privacy
Patients Rights & Grievance Form
Communication & Social Media Policy
Release of Information
For more information or if you have questions, please call our clinic at 262-284-5789.