Forms

To save you some time please download, fill out, and bring these forms to your first appointment.
Click the appropriate group below:

Adult

Please fill out all 3 of these forms.

  1. Medical and Social History form
  2. Office Policy
  3. Demographic Form
Adolescent 12-18 yrs

Please fill out all 3 of these forms.

  1. Adolescent Social History form
  2. Office Policy
  3. Demographic Form
Child 11 yrs and under

Please fill out all 3 of these forms.

  1. Child Social History form
  2. Office Policy
  3. Demographic Form
Release of Information Form

If you would like to coordinate care with another provider (for example; your psychiatrist, primary care physician, your child’s school, etc.), print and complete our release of information form.

1. Authorization to Release Information form