Forms
Please print and complete the forms in this section. Bringing the completed forms with you to your visit will help ensure that our time together is spent addressing your concerns.
INTAKE FORM
This form is fairly self-explanatory. Sometimes the process of writing information helps to clarify the nature of health concerns. If there is a part you aren t comfortable filling out, just skip that part for now. If you want to provide more information than the form allows, feel free to attach an additional page or two.
PRIVACY NOTICE
Please review the Health Insurance Portability and Accountability Act information on this website. (will link to that information here when it comes online. ) You may request a printed copy at the time of your visit. In the interest of conservation we have included the acknowledgement of receipt of this Notice on the consent form (below).
CONSENT FORM
You will notice that we have consolidated several consent forms on one page. This is part of our environmental commitment to reducing paper waste. Please read and sign these consents and feel free to review them and/or ask questions when we are face to face.