Forms

New Client Forms

Fill out your new client forms in the comfort of your own home and email them or bring them to your first appointment.

Please make sure you’ve verified your insurance coverage prior to sending, or bring them in, and also include a copy of your insurance card (front and back). Or, I will make a copy of your insurance card when you come in.

• New Client Registration Form

• Insurance Information Form

• Service Disclosure Form

• Release Authorization Form

• HIPPA Agreement Form

• Summary of Initial Expenses for Child Assessment

• Summary of Initial Expenses for Adult ADHD Evaluation

If you prefer, you can also print and bring your completed forms to your first appointment.

Lastly, if the above options do not work for you, please arrive 30 minutes early to your first appointment to fill out the above forms.

Don’t hesitate to reach out with questions!