Forms

Making it

easier

Forms

If you are a new therapy or assessment patient, you will be sent via email/text the appropriate form packet to complete prior to scheduling if you have not yet done so prior to speaking to our intake coordinator.

If you are directed by our office to complete the forms here, please complete the appropriate form packet listed under "New Patients" within 48 hours of being asked to do so. If you are seeking a bariatric or spinal cord stimulator psychological evaluation, you will need to complete the appropriate packet labeled either "Pre-Surgical Evaluation."

All new patient forms are required to be completed prior to scheduling or within 48 hours of scheduling with a referral.

All new patients must provide a valid ID and insurance card when they complete the form packet.

New Patient Forms

Adult Individual Therapy Adult Individual Therapy - Spanish Minor Individual Therapy Biofeedback Therapy Neuropsychological Evaluation Neuropsychological Evaluation - Spanish Psychological Evaluation Psychological Evaluation - Spanish Pre-Surgical Evaluations Immigration Evaluations Immigration Evaluations - Spanish VA Disability Evaluations

Miscellaneous In-Office Forms*
*Do NOT complete these forms unless told to do so by our staff.

Social Security Disability Release of Information

Other Forms

Notice of Good Faith Estimate Notice of Privacy Practices Patient Experience Survey

In order to reduce waste and speed up the check-in process we have moved to complete digital forms. All forms are completed through our secure HIPAA compliant online forms server.

You may download pdf versions here: New Patient - Adult, New Patient - Minor, New Patient - Biofeedback, New Patient - Pre-Surgical, New Patient - SSDC, and Release of Information.