Please complete these forms prior to your first session. Forms may be completed electronically and emailed to firstname.lastname@example.org or printed and completed.
New Client Information
(If completing electronically please click to create a “checkmark” to the left of the word when the form specifies to “circle” a response).
Self-Pay: Payment Policy
Insurance Coverage: Insurance Payment & Financial Policy
Appointments are scheduled for a specific time. You will be charged 100% for missed appointments unless we are notified of cancellation at least 24 hours in advance, or in cases of emergency.