Forms

Initial Forms 

Professional Services Agreement

Consent for Services

HIPAA Privacy Policies

HIPPA Acknowledgment

Child Demographic Form

Insurance Form

Insurance Billing Agreement

Medication and Allergy List

Declined PCP/MH Provider Authorization

Child Symptom Screening

Patient Stress Questionnaire

 

Ongoing Forms

Authorization to Release Information Form

Therapy on School Grounds form

 

Additional Service Agreements 

Parenting Class Service Agreement