In order to provide the best care possible, we require that parents attend the first appointment. This applies to all clients under the age of 18.

Current/Previous clients please fill out the Registration Packet first:

Registration Packet

Additional Documents Requested for first appointment (Staff and/or your clinician will inform you if you need to complete any of the below documents):

Patient Rights for Medicaid/Tricare Consumers

HIPAA Information/Notice of Privacy Practices

Adult Comprehensive Clinical Assessment Form

Child/Adolescent Comprehensive Clinical Assessment Form

Information for New Clients being seen in Office

Information for New Teletherapy Clients

Coordination of Care Exemption Form

Consent of Treatment for a Minor

Medical Release of Information

Medical Release of Information for Client’s with Medicaid Insurance

Informed Consent for Online Therapy Services

Informed Consent for In Person Therapy Services

Self-Pay Rates

Non-Recording Agreement

Requesting to not have Medical Records Released

Forms needed to be completed when Information has changed:

Contact Information Update

PCL-C/PHQ-9/GAD-7

Geriatric Depression Scale

Photo ID Upload

Insurance Card Upload

Additional Document Upload

• (i.e. Custody paper work, Updated POA, etc.)

Name Change Form

CCS Referral Form