Patient Forms

Once you have made your initial appointment, you can click on the links below to download the New Patient Forms. Please print and complete the forms prior to your arrival. Completing the forms early will expedite your time to been seen by the clinician.

CLICK ON THE SECTIONS BELOW FOR FORMS

Traditional Treatment Form
Consent to Treat
Client Information Form
Coordination of Care
Credit Card Form
Financial Agreement Form
HIPAA/Billing Auth Form
Medication/Pharmacy Form
New Client Intake Forms
Play Therapy Parent Update Form

Assessment Tools and Scale
MDQ
PHQ-9 GAD-7
PHQ-TEENS
LIFE EVENT CHECKLIST
PCL-C
COLUMBIA -SSRS -INITIAL
COLUMBIA -SSRS -FOLLOW UP
VANDERBILT ADHD SCALES – INITIAL
VANDERBILT ADHD SCALES – FOLLOW UP

Other Forms
HIPAA/PHI Form
RELEASE OF INFORMATION FORM

Medication Side Effects
ANTIDEPRESSANTS
MOOD STABILIZERS
ANTIPSYCHOTICS
ANTIOLYTICS (FOR ANXIETY)
STIMULANTS
SLEEP MEDICATIONS

Contacts