If you’re a new client, please complete the following forms and bring them to your first appointment. Note that these forms may have already been sent to you as well in your patient portal on our PHR (Charm). If you have completed them there, you do not need to complete them again, except for any updates. The Credit Card authorization form is only required for individuals engaging in telehealth.
- Patient Information Form
- Patient Information Form – Fillable PDF
- HIPPA Policy
- Informed Consent for Treatment
- Informed Consent for Treatment – Fillable PDF
- Consent / Authorization to Release Records
- Credit Card Authorization Form
- Credit Card Authorization Form – Fillable
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