New Patient Paperwork
For new patients being seen in our office complete Intake Questionaire, Individual History Form and Consent for Treatment Office.
Either print the forms and fill out by hand and bring it to your appointment or you can save the forms to your computer, fill them out and email them to firstname.lastname@example.org before your scheduled appointment.
If you and your therapist have made the decision to use Telehealth therapy
"Sliding Fee Scale Application"
and bring it to your appointment for the therapist to look over.
Please note: A copy of your insurance card is required for us to file your claims. Please email a copy of your card front and back. If you do not have one you will be considered self-pay until you bring your insurance card in.
A minimum of $25.00 will be due at the time of service for all clients with deductible plans.