Forms

Download and complete these forms prior to your first appointment. If you are the responsible party, please complete these forms yourself. If you are not the responsible party, we must obtain written consent of the legal guardian or other authorized legal representative prior to rendering services in the event the client is a minor child, an adult who is legally incompetent, or an adult incapable of giving informed consent.

Cathy’s Clients

Jennifer’s Clients

New Client Questionnaire
Fill it out, sign it, and bring with you to your first appointment or click here to submit online
New Client Questionnaire
Fill it out, sign it, and bring with you to your first appointment or click here to submit online
Informed Consent
Print, sign, and bring with you to your appointment
Informed Consent
Print, sign, and bring with you to your appointment
HIPPA Notice of Privacy
Review and keep for your records
HIPPA Notice of Privacy
Review and keep for your records
HIPPA Acknowledgement
Print, sign, and bring with you to your appointment
HIPPA Acknowledgement
Print, sign, and bring with you to your appointment
Release of Information
Print, fill out, sign, and bring with you to your appointment
Release of Information
Print, fill out, sign, and bring with you to your appointment
Billing Agreement
Print, fill out, sign, and bring with you to your appointment
Billing Agreement
Print, fill out, sign, and bring with you to your appointment

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