Client Forms

Your request will be processed within 24 hours, during normal business hours. If you do not receive confirmation of your request within 48 hours, please contact our office by phone.

For individuals requesting an initial appointment from a clinician, please complete the following form:

• Online Appointment Request Form

For those clients who have scheduled an initial appointment with a clinician, please complete and return the following forms prior to your first appointment:

• Initial Intake Form
• Telehealth Disclosure Form
• Informed Consent Agreement and HIPAA Notice of Privacy Practices
• Acknowledgement of Psychiatric Treatment Policies
• Credit Card Authorization Form
• DBT Skills Group Informed Consent Agreement

Download Client Forms

Before your appointment with us, quickly and conveniently access our client forms.

To view the forms listed below, you will need to download Adobe Reader. Please complete these forms and submit them to us prior to your appointment.

• New Client Questionnaire
• Client Self Assessment Form
• Coordination of Behavioral Health Care Form
• Authorization to Release/Receive Information
• Client Satisfaction Questionnaire