Register on our Patient Portal and click on the "Intake Paperwork" link to submit new client paperwork.
See below for printable Client Forms.
New Intake Paperwork.Demographics (pdf)
DownloadInformed Consent.Adult (pdf)
DownloadInformed Consent.Child and Adolescent.Revised 7.1.26 (pdf)
DownloadAI Consent (pdf)
DownloadRelease of Information of PHI (pdf)
DownloadConsent to Treatment for Minors.8.1.2024 (pdf)
DownloadMagellan Member Rights and Responsibilies (pdf)
DownloadPayment Agreement CC on File (pdf)
DownloadGood Faith Estimate.8.1.24 (pdf)
DownloadSliding Fee Application (pdf)
DownloadWraparound Agency Flyer (pdf)
DownloadAre you ready to get on the path to a healthier you? Get in touch today to get started!
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