Forms

pdfNew Patient Information

pdfPatient Treatment and Medical History

pdfNotice of Privacy Practices

pdfConsent for Uses and Disclosures to Carry Out Treatment, Payment and Health Care Operation

pdfOffice Policies and General Information Agreement for Psychotherapy Service's

 

Instructions for Fill-in Forms:

Opening the Form

Your web browser may be configured with an Adobe Reader plug-in to automatically open the file within your browser's window when accessed. We recommend you save the PDF file to your computer and access the file locally.  This allows the full Adobe Reader application to interface with the product.  To download the file directly to your local drive, right click on the Link for the form then select "Save Target/Link As..." from the menu. Use Adobe Reader to open the file. Adobe Acrobat Reader is freely available by clicking here.

Fill-in forms with the ability to save locally may generate a dialog/message box when opened within Adobe Reader. If you are using Adobe Reader 8.16 or later, the dialog box will indicate that document rights have been applied to the PDF file and you can save the completed fill-in form. If you are using a version of Adobe Reader prior to Version 8.16, the dialog box will indicate that some features of the document will not operate and you will be prompted to obtain a newer version of Adobe Reader. We recommend using Adobe Reader 8.16.

Completing the Form

When positioning the cursor on a fill-in area or element, the cursor will change appearance. The I-beam pointer allows you to type text. The hand pointer allows you to select a check box or radio button. Enter the appropriate data in each box or field. To move from one field to the next, press the Tab key. You can also use your cursor to move from field to field. Place your cursor in the field you want to fill in, then left-click. Some fields limit the maximum number of characters you can enter and may automatically advance to the next field.

For additional help with fill-in forms, see the Adobe Reader's online help information.

Adobe Acrobat Reader

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