Child Forms

These forms are for clients that are under 18 years of age. Please read, print, fill-out and sign these forms and bring them to your first office visit. Thank you

Secure Online Forms (No Paper!)

Child Patient Information

Child Patient 2021 Form Update

Consent for Release of Information

Teletherapy Consent Form

Informed Consent Form For In-Person Services During COVID-19 Crisis

Psychological Evaluation Fee Agreement for Non-Covered Services

Joint Custody Consent Form

 

PDF Instructions

Video Visit Instructions for Clients

 

PDF Forms

Credit Card Authorization Form

Child Patient Information

Child Patient 2021 Form Update

Consent for Release of Information

Teletherapy Consent Form

Informed Consent Form for In-Person Services During COVID-19 Crisis

Psychological Evaluation Fee Agreement for Non-Covered Services